Provider Demographics
NPI:1841961406
Name:BIETZ, ERIN KATHERINE
Entity type:Individual
Prefix:DR
First Name:ERIN
Middle Name:KATHERINE
Last Name:BIETZ
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 1:100 N MAIN ST APT 405
Mailing Address - Street 2:
Mailing Address - City:MOUNT PLEASANT
Mailing Address - State:IA
Mailing Address - Zip Code:52641-2190
Mailing Address - Country:US
Mailing Address - Phone:319-524-9535
Mailing Address - Fax:
Practice Address - Street 1:1700 E WASHINGTON ST
Practice Address - Street 2:
Practice Address - City:MOUNT PLEASANT
Practice Address - State:IA
Practice Address - Zip Code:52641-3210
Practice Address - Country:US
Practice Address - Phone:319-986-6979
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-09-23
Last Update Date:2022-10-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA24290183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist