Provider Demographics
NPI:1245834563
Name:ROGOWSKI, KELSEY MICHELLE (PHARMD)
Entity type:Individual
Prefix:MRS
First Name:KELSEY
Middle Name:MICHELLE
Last Name:ROGOWSKI
Suffix:
Gender:
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:724 AMES AVE
Mailing Address - Street 2:
Mailing Address - City:PALO ALTO
Mailing Address - State:CA
Mailing Address - Zip Code:94303-4129
Mailing Address - Country:US
Mailing Address - Phone:720-234-5396
Mailing Address - Fax:
Practice Address - Street 1:855 EL CAMINO REAL
Practice Address - Street 2:
Practice Address - City:PALO ALTO
Practice Address - State:CA
Practice Address - Zip Code:94301-2305
Practice Address - Country:US
Practice Address - Phone:650-322-2644
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-11-27
Last Update Date:2025-04-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GARPH0308931835P0018X
CO231101835P0018X
CA88969183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist
No1835P0018XPharmacy Service ProvidersPharmacistPharmacist Clinician (PhC)/ Clinical Pharmacy Specialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
GARPH030893OtherGEORGIA BOARD OF PHARMACY
RPH88969OtherCALIFORNIA BOARD OF PHARMACY
CO23110OtherCOLORADO BOARD OF PHARMACY