Provider Demographics
NPI:1063097665
Name:GEISLER, KAREN G
Entity type:Individual
Prefix:
First Name:KAREN
Middle Name:G
Last Name:GEISLER
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 1:5902 WOODPARK DR
Mailing Address - Street 2:
Mailing Address - City:MIDLAND
Mailing Address - State:MI
Mailing Address - Zip Code:48640-2735
Mailing Address - Country:US
Mailing Address - Phone:772-285-9253
Mailing Address - Fax:
Practice Address - Street 1:910 JOE MANN BLVD
Practice Address - Street 2:
Practice Address - City:MIDLAND
Practice Address - State:MI
Practice Address - Zip Code:48642-8903
Practice Address - Country:US
Practice Address - Phone:989-835-6364
Practice Address - Fax:989-835-1984
Is Sole Proprietor?:No
Enumeration Date:2021-03-15
Last Update Date:2021-03-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLRPT2900183700000X
MI5303031526183700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183700000XPharmacy Service ProvidersPharmacy Technician