Provider Demographics
NPI:1922383884
Name:GEIDEL, ANNE M (RPH)
Entity Type:Individual
Prefix:MRS
First Name:ANNE
Middle Name:M
Last Name:GEIDEL
Suffix:
Gender:F
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11 SUNSET DRIVE
Mailing Address - Street 2:
Mailing Address - City:HESSTON
Mailing Address - State:KS
Mailing Address - Zip Code:67062-9139
Mailing Address - Country:US
Mailing Address - Phone:620-217-9225
Mailing Address - Fax:
Practice Address - Street 1:1300 N. MAIN
Practice Address - Street 2:
Practice Address - City:NEWTON
Practice Address - State:KS
Practice Address - Zip Code:67114
Practice Address - Country:US
Practice Address - Phone:316-281-9356
Practice Address - Fax:316-281-9335
Is Sole Proprietor?:No
Enumeration Date:2011-10-11
Last Update Date:2011-10-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS11665183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist