Provider Demographics
NPI:1558477398
Name:KIEFER, ROSEANN B (BC-HIS)
Entity Type:Individual
Prefix:
First Name:ROSEANN
Middle Name:B
Last Name:KIEFER
Suffix:
Gender:F
Credentials:BC-HIS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:130 S COMMERCE AVE
Mailing Address - Street 2:
Mailing Address - City:SEBRING
Mailing Address - State:FL
Mailing Address - Zip Code:33870-3601
Mailing Address - Country:US
Mailing Address - Phone:863-385-3497
Mailing Address - Fax:863-385-8201
Practice Address - Street 1:130 S COMMERCE AVE
Practice Address - Street 2:
Practice Address - City:SEBRING
Practice Address - State:FL
Practice Address - Zip Code:33870-3601
Practice Address - Country:US
Practice Address - Phone:863-385-3497
Practice Address - Fax:863-385-8201
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-22
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLAS1504237700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes237700000XSpeech, Language and Hearing Service ProvidersHearing Instrument Specialist