Provider Demographics
NPI:1285304808
Name:KISER, JORDAN N (PHARMD)
Entity type:Individual
Prefix:DR
First Name:JORDAN
Middle Name:N
Last Name:KISER
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 1:414 MAIN ST
Mailing Address - Street 2:
Mailing Address - City:QUINTER
Mailing Address - State:KS
Mailing Address - Zip Code:67752-5205
Mailing Address - Country:US
Mailing Address - Phone:785-754-3312
Mailing Address - Fax:785-754-3844
Practice Address - Street 1:414 MAIN ST
Practice Address - Street 2:
Practice Address - City:QUINTER
Practice Address - State:KS
Practice Address - Zip Code:67752-5205
Practice Address - Country:US
Practice Address - Phone:785-754-3312
Practice Address - Fax:785-754-3844
Is Sole Proprietor?:No
Enumeration Date:2021-09-15
Last Update Date:2022-11-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS1-109396183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist