Individual
KELLI HENRY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
4809 QUIVIRA DR, SHAWNEE, KS 66216-1154
(865) 567-7285
Mailing address
4809 QUIVIRA DR, SHAWNEE, KS 66216-1154
Taxonomy
Speciality
Code
Description
License number
State
3336I0012X
Institutional Pharmacy
Primary
RPH031395
GA
Other
Enumeration date
10/21/2025
Last updated
10/21/2025
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