Provider Demographics
NPI:1275819138
Name:KIERATH, ASHLEY LAUREN (PHARMD)
Entity Type:Individual
Prefix:MS
First Name:ASHLEY
Middle Name:LAUREN
Last Name:KIERATH
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 1:1301 S 5TH STREET
Mailing Address - Street 2:
Mailing Address - City:SAINT CHARLES
Mailing Address - State:MO
Mailing Address - Zip Code:63301-2457
Mailing Address - Country:US
Mailing Address - Phone:636-946-6210
Mailing Address - Fax:636-946-9273
Practice Address - Street 1:1301 S 5TH STREET
Practice Address - Street 2:
Practice Address - City:SAINT CHARLES
Practice Address - State:MO
Practice Address - Zip Code:63301-2457
Practice Address - Country:US
Practice Address - Phone:636-946-6210
Practice Address - Fax:636-946-9273
Is Sole Proprietor?:Yes
Enumeration Date:2011-10-24
Last Update Date:2011-10-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2011027347183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist