Provider Demographics
NPI:1578318846
Name:KLIEWER-MILLS, ABIGAIL RAY (PHARMD)
Entity Type:Individual
Prefix:
First Name:ABIGAIL
Middle Name:RAY
Last Name:KLIEWER-MILLS
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 1:12225 N 1800 RD
Mailing Address - Street 2:
Mailing Address - City:ERICK
Mailing Address - State:OK
Mailing Address - Zip Code:73645-5557
Mailing Address - Country:US
Mailing Address - Phone:580-660-1994
Mailing Address - Fax:
Practice Address - Street 1:12225 N 1800 RD
Practice Address - Street 2:
Practice Address - City:ERICK
Practice Address - State:OK
Practice Address - Zip Code:73645-5557
Practice Address - Country:US
Practice Address - Phone:580-660-1994
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-04-20
Last Update Date:2024-04-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK20442183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist