Provider Demographics
NPI:1457998239
Name:KISER, CARA LYNN
Entity Type:Individual
Prefix:
First Name:CARA
Middle Name:LYNN
Last Name:KISER
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3060 N NATIONAL RD
Mailing Address - Street 2:
Mailing Address - City:COLUMBUS
Mailing Address - State:IN
Mailing Address - Zip Code:47201-3236
Mailing Address - Country:US
Mailing Address - Phone:812-376-9566
Mailing Address - Fax:812-378-8628
Practice Address - Street 1:3060 N NATIONAL RD
Practice Address - Street 2:
Practice Address - City:COLUMBUS
Practice Address - State:IN
Practice Address - Zip Code:47201-3236
Practice Address - Country:US
Practice Address - Phone:812-376-9566
Practice Address - Fax:812-378-8628
Is Sole Proprietor?:No
Enumeration Date:2019-11-29
Last Update Date:2019-11-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN26020976A183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist