Most Relevant Information
Provider Data
| NPI Number: | 1003404559 |
| Provider Name: | KELLY UYEN KHIEU |
| Entity Type: | Individual |
| Taxonomy Code: | 183500000X |
| Specialty: | Pharmacist |
| License Number: | 117298 |
Most Important Dates
| Enumeration Date: | 01/08/2021 |
| Last Updated: | 01/08/2021 |
Provider Practice Location
9655 COLORADO LN N
BROOKLYN PARK
MN
554452315
Practice Location Phone/Fax
| Phone: | 7633150737 |
| Fax: |
Provider Mailing Location
9655 COLORADO LN N
BROOKLYN PARK
MN
554452315
Provider Mailing Phone/Fax
| Phone: | |
| Fax: |