Provider Demographics
NPI:1881978070
Name:HSU, KERRIE MAU (PHARMD)
Entity type:Individual
Prefix:MRS
First Name:KERRIE
Middle Name:MAU
Last Name:HSU
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:MS
Other - First Name:CHUNG
Other - Middle Name:
Other - Last Name:MAU
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:9010 MICHIGAN RD
Mailing Address - Street 2:
Mailing Address - City:INDIANAPOLIS
Mailing Address - State:IN
Mailing Address - Zip Code:46268-3184
Mailing Address - Country:US
Mailing Address - Phone:317-532-1607
Mailing Address - Fax:317-532-1628
Practice Address - Street 1:9010 MICHIGAN RD
Practice Address - Street 2:
Practice Address - City:INDIANAPOLIS
Practice Address - State:IN
Practice Address - Zip Code:46268-3184
Practice Address - Country:US
Practice Address - Phone:317-532-1607
Practice Address - Fax:317-532-1628
Is Sole Proprietor?:No
Enumeration Date:2011-10-05
Last Update Date:2018-10-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA51838183500000X
IN26020395A183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist