Provider Demographics
NPI:1013531359
Name:NIEMI, KAREN LOUISE (RPH)
Entity Type:Individual
Prefix:
First Name:KAREN
Middle Name:LOUISE
Last Name:NIEMI
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 1:2412 17TH ST
Mailing Address - Street 2:
Mailing Address - City:DE WITT
Mailing Address - State:IA
Mailing Address - Zip Code:52742-9184
Mailing Address - Country:US
Mailing Address - Phone:563-659-3544
Mailing Address - Fax:
Practice Address - Street 1:316 WASHINGTON ST
Practice Address - Street 2:
Practice Address - City:PROPHETSTOWN
Practice Address - State:IL
Practice Address - Zip Code:61277-1184
Practice Address - Country:US
Practice Address - Phone:815-537-2400
Practice Address - Fax:815-537-2404
Is Sole Proprietor?:Yes
Enumeration Date:2020-06-02
Last Update Date:2020-06-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA17862183500000X
IL051286610183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist