Provider Demographics
NPI:1922261015
Name:WIEST, TIERA M (PHARMD)
Entity Type:Individual
Prefix:DR
First Name:TIERA
Middle Name:M
Last Name:WIEST
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 1:11091 HICKLIN HOLLOW RD
Mailing Address - Street 2:
Mailing Address - City:PRAIRIE DU CHIEN
Mailing Address - State:WI
Mailing Address - Zip Code:53821-9529
Mailing Address - Country:US
Mailing Address - Phone:608-438-4855
Mailing Address - Fax:
Practice Address - Street 1:109 N MARQUETTE RD
Practice Address - Street 2:
Practice Address - City:PRAIRIE DU CHIEN
Practice Address - State:WI
Practice Address - Zip Code:53821-1512
Practice Address - Country:US
Practice Address - Phone:608-326-0581
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-07-08
Last Update Date:2024-02-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI15198-40183500000X
IA23807183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist