Provider Demographics
NPI:1366742421
Name:OLERU, KIONNA R (PHARM D)
Entity type:Individual
Prefix:DR
First Name:KIONNA
Middle Name:R
Last Name:OLERU
Suffix:
Gender:F
Credentials:PHARM D
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7172 COLUMBIA GATEWAY DR
Mailing Address - Street 2:SUITE 300
Mailing Address - City:COLUMBIA
Mailing Address - State:MD
Mailing Address - Zip Code:21046-2990
Mailing Address - Country:US
Mailing Address - Phone:443-518-7000
Mailing Address - Fax:
Practice Address - Street 1:7172 COLUMBIA GATEWAY DR
Practice Address - Street 2:SUITE 300
Practice Address - City:COLUMBIA
Practice Address - State:MD
Practice Address - Zip Code:21046-2990
Practice Address - Country:US
Practice Address - Phone:443-518-7000
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-10-23
Last Update Date:2013-10-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DCPH100000452183500000X
MD18489183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist