Provider Demographics
NPI:1104103019
Name:STROEH, KIMBERLY MARIE (PHARMD)
Entity type:Individual
Prefix:
First Name:KIMBERLY
Middle Name:MARIE
Last Name:STROEH
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 1:4650 MORNINGSIDE AVE
Mailing Address - Street 2:
Mailing Address - City:SIOUX CITY
Mailing Address - State:IA
Mailing Address - Zip Code:51106-2964
Mailing Address - Country:US
Mailing Address - Phone:712-276-7744
Mailing Address - Fax:712-276-3377
Practice Address - Street 1:4650 MORNINGSIDE AVE
Practice Address - Street 2:
Practice Address - City:SIOUX CITY
Practice Address - State:IA
Practice Address - Zip Code:51106-2964
Practice Address - Country:US
Practice Address - Phone:712-276-7744
Practice Address - Fax:712-276-3377
Is Sole Proprietor?:No
Enumeration Date:2011-11-05
Last Update Date:2011-11-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE13749183500000X
SD5902183500000X
IA21560183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist