Provider Demographics
NPI:1568458552
Name:WEIS, KAREN ELAINE (RPH)
Entity Type:Individual
Prefix:MS
First Name:KAREN
Middle Name:ELAINE
Last Name:WEIS
Suffix:
Gender:F
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:1700 W TOWNLINE ST
Mailing Address - Street 2:SUITE 3
Mailing Address - City:CRESTON
Mailing Address - State:IA
Mailing Address - Zip Code:50801-1054
Mailing Address - Country:US
Mailing Address - Phone:641-782-3511
Mailing Address - Fax:641-782-3846
Practice Address - Street 1:1700 W TOWNLINE ST
Practice Address - Street 2:SUITE 3
Practice Address - City:CRESTON
Practice Address - State:IA
Practice Address - Zip Code:50801-1054
Practice Address - Country:US
Practice Address - Phone:641-782-3511
Practice Address - Fax:641-782-3846
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-09-23
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
IA17197183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist