Provider Demographics
NPI:1245440270
Name:KISER, CAROL ANGELA (PHARM D)
Entity type:Individual
Prefix:DR
First Name:CAROL
Middle Name:ANGELA
Last Name:KISER
Suffix:
Gender:F
Credentials:PHARM D
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:132 TIMBER RIDGE DR
Mailing Address - Street 2:
Mailing Address - City:PELLA
Mailing Address - State:IA
Mailing Address - Zip Code:50219-7847
Mailing Address - Country:US
Mailing Address - Phone:641-625-1185
Mailing Address - Fax:641-628-3625
Practice Address - Street 1:118 SE 9TH ST
Practice Address - Street 2:HY-VEE
Practice Address - City:PELLA
Practice Address - State:IA
Practice Address - Zip Code:50219-2200
Practice Address - Country:US
Practice Address - Phone:641-628-1280
Practice Address - Fax:641-628-3625
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-22
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA19791183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist