Provider Demographics
NPI:1194447615
Name:SIEBS, KILEY CONRAD (PHARMD)
Entity type:Individual
Prefix:
First Name:KILEY
Middle Name:CONRAD
Last Name:SIEBS
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 1:14623 S BOND ST
Mailing Address - Street 2:
Mailing Address - City:OLATHE
Mailing Address - State:KS
Mailing Address - Zip Code:66062-5160
Mailing Address - Country:US
Mailing Address - Phone:913-449-9639
Mailing Address - Fax:
Practice Address - Street 1:8101 W 151ST ST
Practice Address - Street 2:
Practice Address - City:OVERLAND PARK
Practice Address - State:KS
Practice Address - Zip Code:66223-2113
Practice Address - Country:US
Practice Address - Phone:913-905-0420
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-09-12
Last Update Date:2022-09-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS1-13146183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist