Provider Demographics
NPI:1205188489
Name:STOTTISH, KIRA LINETTE (PHARMD)
Entity Type:Individual
Prefix:DR
First Name:KIRA
Middle Name:LINETTE
Last Name:STOTTISH
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:318 OSBORNE AVE
Mailing Address - Street 2:
Mailing Address - City:FALLS CREEK
Mailing Address - State:PA
Mailing Address - Zip Code:15840-4444
Mailing Address - Country:US
Mailing Address - Phone:814-591-8700
Mailing Address - Fax:
Practice Address - Street 1:431 COMMONS DR
Practice Address - Street 2:
Practice Address - City:DU BOIS
Practice Address - State:PA
Practice Address - Zip Code:15801-3815
Practice Address - Country:US
Practice Address - Phone:814-371-4491
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-10-11
Last Update Date:2012-10-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PARPI006654183500000X
PARP4470851835P1200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1835P1200XPharmacy Service ProvidersPharmacistPharmacotherapy
No183500000XPharmacy Service ProvidersPharmacist