Provider Demographics
NPI:1679187611
Name:BIEBERLE, ALLISON JO (PHARMD)
Entity Type:Individual
Prefix:
First Name:ALLISON
Middle Name:JO
Last Name:BIEBERLE
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 1:700 N MAIN ST
Mailing Address - Street 2:
Mailing Address - City:EL DORADO
Mailing Address - State:KS
Mailing Address - Zip Code:67042-4526
Mailing Address - Country:US
Mailing Address - Phone:316-321-0318
Mailing Address - Fax:316-321-8810
Practice Address - Street 1:700 N MAIN ST
Practice Address - Street 2:
Practice Address - City:EL DORADO
Practice Address - State:KS
Practice Address - Zip Code:67042-4526
Practice Address - Country:US
Practice Address - Phone:316-321-0318
Practice Address - Fax:316-321-8810
Is Sole Proprietor?:No
Enumeration Date:2020-09-08
Last Update Date:2020-09-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS1-1008091835P0018X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1835P0018XPharmacy Service ProvidersPharmacistPharmacist Clinician (PhC)/ Clinical Pharmacy Specialist