Provider Demographics
NPI:1710121892
Name:KISER, IMEE SARMIENTO (IDMT)
Entity Type:Individual
Prefix:MRS
First Name:IMEE
Middle Name:SARMIENTO
Last Name:KISER
Suffix:
Gender:F
Credentials:IDMT
Other - Prefix:MISS
Other - First Name:IMEE
Other - Middle Name:SARMIENTO
Other - Last Name:CASTANETO
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:UNIT 14010
Mailing Address - Street 2:
Mailing Address - City:APO
Mailing Address - State:AP
Mailing Address - Zip Code:96543-4010
Mailing Address - Country:US
Mailing Address - Phone:671-366-3231
Mailing Address - Fax:
Practice Address - Street 1:36TH MDG
Practice Address - Street 2:BUILDING 26012 CAROLINES AVENUE
Practice Address - City:ANDERSEN AFB
Practice Address - State:GU
Practice Address - Zip Code:96542
Practice Address - Country:US
Practice Address - Phone:671-366-3231
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2009-04-21
Last Update Date:2018-05-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1710I1003XOther Service ProvidersMilitary Health Care ProviderIndependent Duty Medical Technicians