1396101408 NPI number — DR. KAREN LYNNE EISENBIEGLER PHARMD

Table of content: DR. KAREN LYNNE EISENBIEGLER PHARMD (NPI 1396101408)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1396101408 NPI number — DR. KAREN LYNNE EISENBIEGLER PHARMD

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
EISENBIEGLER
Provider First Name:
KAREN
Provider Middle Name:
LYNNE
Provider Name Prefix Text:
DR.
Provider Name Suffix Text:
Provider Credential Text:
PHARMD
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1396101408
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
12/02/2021
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
PO BOX 10
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
PINON
Provider Business Mailing Address State Name:
AZ
Provider Business Mailing Address Postal Code:
86510-0010
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
928-725-9514
Provider Business Mailing Address Fax Number:
928-725-9542

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
NAVAJO ROUTE 4
Provider Second Line Business Practice Location Address:
2 MILES EAST OF PINON
Provider Business Practice Location Address City Name:
PINON
Provider Business Practice Location Address State Name:
AZ
Provider Business Practice Location Address Postal Code:
86510-0010
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
928-725-9514
Provider Business Practice Location Address Fax Number:
928-725-9542
Provider Enumeration Date:
01/05/2016

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 1835P2201X , with the licence number:  033.0003831 , registered in the state of VT ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 1835P2201X , with the licence number: S025610 , registered in the state of AZ ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)





Copyright © 2007-2025 www.npivalidator.com