Provider Demographics
NPI:1730780271
Name:LAMB, KELLI MICHELLE (PHARMD)
Entity type:Individual
Prefix:MRS
First Name:KELLI
Middle Name:MICHELLE
Last Name:LAMB
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1592 S LOOP 288 # A
Mailing Address - Street 2:
Mailing Address - City:DENTON
Mailing Address - State:TX
Mailing Address - Zip Code:76205-4730
Mailing Address - Country:US
Mailing Address - Phone:940-566-5252
Mailing Address - Fax:940-566-5454
Practice Address - Street 1:1592 S LOOP 288 # A
Practice Address - Street 2:
Practice Address - City:DENTON
Practice Address - State:TX
Practice Address - Zip Code:76205-4730
Practice Address - Country:US
Practice Address - Phone:940-566-5252
Practice Address - Fax:940-566-5252
Is Sole Proprietor?:No
Enumeration Date:2020-11-02
Last Update Date:2020-11-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX55054183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist