Provider Demographics
NPI:1184255069
Name:KINDLEY, PAIGE ELIZABETH (PHARMD)
Entity type:Individual
Prefix:
First Name:PAIGE
Middle Name:ELIZABETH
Last Name:KINDLEY
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:
Other - First Name:PAIGE
Other - Middle Name:ELIZABETH
Other - Last Name:VORTMAN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:205 N E ST
Mailing Address - Street 2:
Mailing Address - City:OSKALOOSA
Mailing Address - State:IA
Mailing Address - Zip Code:52577-2016
Mailing Address - Country:US
Mailing Address - Phone:641-673-3439
Mailing Address - Fax:641-673-3945
Practice Address - Street 1:205 N E ST
Practice Address - Street 2:
Practice Address - City:OSKALOOSA
Practice Address - State:IA
Practice Address - Zip Code:52577-2016
Practice Address - Country:US
Practice Address - Phone:641-673-3439
Practice Address - Fax:641-673-3945
Is Sole Proprietor?:No
Enumeration Date:2020-01-30
Last Update Date:2020-01-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA23372183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist