Provider Demographics
NPI:1811958226
Name:KISER, ANGELA P (MS CCC A)
Entity type:Individual
Prefix:
First Name:ANGELA
Middle Name:P
Last Name:KISER
Suffix:
Gender:F
Credentials:MS CCC A
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2951 FRONT STREET
Mailing Address - Street 2:SUITE 2500 MEDICAL PLAZA ASSOCIATED HEARING AND DIAGNO
Mailing Address - City:RICHLANDS
Mailing Address - State:VA
Mailing Address - Zip Code:24651-2055
Mailing Address - Country:US
Mailing Address - Phone:276-964-7465
Mailing Address - Fax:276-963-3507
Practice Address - Street 1:2951 FRONT STREET
Practice Address - Street 2:SUITE 2500 MEDICAL PLAZA ASSOCIATED HEARING AND DIAGNO
Practice Address - City:RICHLANDS
Practice Address - State:VA
Practice Address - Zip Code:24651-2055
Practice Address - Country:US
Practice Address - Phone:276-964-7465
Practice Address - Fax:276-963-3507
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-03-28
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA2201000684231H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes231H00000XSpeech, Language and Hearing Service ProvidersAudiologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
S69917Medicare UPIN