Provider Demographics
NPI:1316334220
Name:MEYER, ABBY KATHLEEN (PHARMD)
Entity type:Individual
Prefix:MS
First Name:ABBY
Middle Name:KATHLEEN
Last Name:MEYER
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 1:1972 AMANA RD NW
Mailing Address - Street 2:
Mailing Address - City:SWISHER
Mailing Address - State:IA
Mailing Address - Zip Code:52338-9796
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:1847 1ST AVE SE
Practice Address - Street 2:SUITE 100
Practice Address - City:CEDAR RAPIDS
Practice Address - State:IA
Practice Address - Zip Code:52402-5449
Practice Address - Country:US
Practice Address - Phone:866-451-8804
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-04-17
Last Update Date:2015-04-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA21079183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist
Provider Identifiers
StateIdentifier IDID TypeIssuer
IA21079OtherIOWA BOARD OF PHARMACY