Provider Demographics
NPI:1053936013
Name:BENZING, KELSA LOUISE (PHARMD, RPH)
Entity type:Individual
Prefix:
First Name:KELSA
Middle Name:LOUISE
Last Name:BENZING
Suffix:
Gender:F
Credentials:PHARMD, RPH
Other - Prefix:
Other - First Name:KELSA
Other - Middle Name:LOUISE
Other - Last Name:HERNLEY
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:4750 E 450 S
Mailing Address - Street 2:
Mailing Address - City:WHITESTOWN
Mailing Address - State:IN
Mailing Address - Zip Code:46075-8404
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:4750 E 450 S
Practice Address - Street 2:
Practice Address - City:WHITESTOWN
Practice Address - State:IN
Practice Address - Zip Code:46075-8404
Practice Address - Country:US
Practice Address - Phone:877-732-3431
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-06-15
Last Update Date:2023-06-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN26027766A183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist