Provider Demographics
NPI:1669770293
Name:KISER, LORI E (PHARMD)
Entity type:Individual
Prefix:DR
First Name:LORI
Middle Name:E
Last Name:KISER
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:995 BETHANIA RURAL HALL RD
Mailing Address - Street 2:
Mailing Address - City:RURAL HALL
Mailing Address - State:NC
Mailing Address - Zip Code:27045-9554
Mailing Address - Country:US
Mailing Address - Phone:336-969-9153
Mailing Address - Fax:336-969-0452
Practice Address - Street 1:995 BETHANIA RURAL HALL RD
Practice Address - Street 2:
Practice Address - City:RURAL HALL
Practice Address - State:NC
Practice Address - Zip Code:27045-9554
Practice Address - Country:US
Practice Address - Phone:336-969-9153
Practice Address - Fax:336-969-0452
Is Sole Proprietor?:No
Enumeration Date:2011-03-07
Last Update Date:2011-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC18243183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC0346725Medicaid
NC0346725Medicaid