Basic Information
| Provider Information | |||||||||
| NPI: | 1194981886 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | GABEL | ||||||||
| FirstName: | KELLY | ||||||||
| MiddleName: | ANN | ||||||||
| NamePrefix: | DR. | ||||||||
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| Credential: | PHARM.D. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 2920 BRUNE RD | ||||||||
| Address2: | |||||||||
| City: | FARMINGTON | ||||||||
| State: | MO | ||||||||
| PostalCode: | 636407147 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5737015910 | ||||||||
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| Practice Location | |||||||||
| Address1: | 1010 W COLUMBIA ST | ||||||||
| Address2: | PHARMACY DEPARTMENT | ||||||||
| City: | FARMINGTON | ||||||||
| State: | MO | ||||||||
| PostalCode: | 636402902 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5732187022 | ||||||||
| FaxNumber: | 5732186762 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 08/01/2008 | ||||||||
| LastUpdateDate: | 08/01/2008 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 1835P0018X | 200880013818 | MO | Y | Pharmacy Service Providers | Pharmacist | Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist |
No ID Information.