Individual
COURTNEY KELLER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PHARMD
Contact information
Practice address
300 S SCHOOL ST, DERMOTT, AR 71638-2127
(870) 538-5414
Mailing address
300 S SCHOOL ST, DERMOTT, AR 71638-2127
(879) 538-5414
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
PD15085
AR
1835P2201X
Ambulatory Care Pharmacist
PD15085
AR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
PD15085
PHARMACIST LICENSE
AR
Enumeration date
12/02/2020
Last updated
12/02/2020
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