Provider Demographics
NPI:1659029056
Name:MANYARA, KIRA (PHARMD, MSCR)
Entity Type:Individual
Prefix:DR
First Name:KIRA
Middle Name:
Last Name:MANYARA
Suffix:
Gender:F
Credentials:PHARMD, MSCR
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1121 MAPLEBECK ENCLAVE NE
Mailing Address - Street 2:
Mailing Address - City:BYRON
Mailing Address - State:MN
Mailing Address - Zip Code:55920-1585
Mailing Address - Country:US
Mailing Address - Phone:910-705-5902
Mailing Address - Fax:
Practice Address - Street 1:80 14TH ST SW
Practice Address - Street 2:
Practice Address - City:ROCHESTER
Practice Address - State:MN
Practice Address - Zip Code:55902-3810
Practice Address - Country:US
Practice Address - Phone:507-206-5132
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-03-15
Last Update Date:2022-03-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN124229183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist