Individual
AMY KRISTINE KELLEY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RPH
Contact information
Practice address
3728 N PRINCE ST, CLOVIS, NM 88101-9744
(575) 769-2389
Mailing address
2320 FAIRWAY TER, CLOVIS, NM 88101-2724
(575) 763-4161
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
5544
NM
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
5544
NEW MEXICO BOARD OF PHARMACY LICENSE NUMBER
NM
Enumeration date
10/01/2009
Last updated
02/23/2014
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