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NPI Code Detail

MEDICARE: DR. JENNA ELAINE KEISTER PHARM.D.

MEDICARE: DR. JENNA ELAINE KEISTER PHARM.D.
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1183500000XPharmacistS026014AZ

General Provider Information

NPI Number : 1770203853
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. JENNA ELAINE KEISTER PHARM.D.
Provider Business Mailing Address
First Line : 280 S EVERGREEN RD UNIT 1390
Second Line :
City : TEMPE
State : AZ
Zip : 85288-5093
Country : US
Telephone Number : 623-866-2664
Fax Number :
Provider Business Practice Location Address
First Line : 2302 N CENTRAL AVE STE 7
Second Line :
City : PHOENIX
State : AZ
Zip : 85004-1332
Country : US
Telephone Number : 602-313-2042
Fax Number : 602-313-2044
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/30/2022
Last Update Date : 08/30/2022

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