# KELLY KOON

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- **Entity:** Individual
- **Status:** Active
- **Sole proprietor:** No

## Provider details

- **NPI number:** 1891365060
- **Gender:** F
- **Credential:** PHARMD

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 183500000X | Pharmacist | 0023992 | CO | Yes |
| 183500000X | Pharmacist | PR70620 | ME | — |
| 183700000X | Pharmacy Technician | PI70419 | ME | — |

## Other

- **Enumeration date:** 06/29/2021
- **Last updated:** 08/03/2023