Provider Demographics
NPI:1205320520
Name:IDDINGS, SIERRA D (PHARMACY INTERN)
Entity type:Individual
Prefix:
First Name:SIERRA
Middle Name:D
Last Name:IDDINGS
Suffix:
Gender:F
Credentials:PHARMACY INTERN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10050 INNOVATION DR STE 200
Mailing Address - Street 2:
Mailing Address - City:MIAMISBURG
Mailing Address - State:OH
Mailing Address - Zip Code:45342-4935
Mailing Address - Country:US
Mailing Address - Phone:937-558-3267
Mailing Address - Fax:
Practice Address - Street 1:10050 INNOVATION DR STE 200
Practice Address - Street 2:
Practice Address - City:MIAMISBURG
Practice Address - State:OH
Practice Address - Zip Code:45342-4935
Practice Address - Country:US
Practice Address - Phone:937-558-3267
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-06-20
Last Update Date:2018-06-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program