Provider Demographics
NPI:1568001311
Name:PARENZA, TALIA KAE (PHARMD)
Entity Type:Individual
Prefix:
First Name:TALIA
Middle Name:KAE
Last Name:PARENZA
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 1:2453 N COURT ST
Mailing Address - Street 2:
Mailing Address - City:OTTUMWA
Mailing Address - State:IA
Mailing Address - Zip Code:52501-1175
Mailing Address - Country:US
Mailing Address - Phone:641-684-1853
Mailing Address - Fax:641-683-5949
Practice Address - Street 1:2453 N COURT ST
Practice Address - Street 2:
Practice Address - City:OTTUMWA
Practice Address - State:IA
Practice Address - Zip Code:52501-1175
Practice Address - Country:US
Practice Address - Phone:641-684-1853
Practice Address - Fax:641-683-5949
Is Sole Proprietor?:No
Enumeration Date:2019-12-26
Last Update Date:2019-12-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA20578183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist