Provider Demographics
NPI:1417786633
Name:EISELE, CIERA JEAN
Entity type:Individual
Prefix:
First Name:CIERA
Middle Name:JEAN
Last Name:EISELE
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 1:118 HAINA CT UNIT 103
Mailing Address - Street 2:
Mailing Address - City:WAHIAWA
Mailing Address - State:HI
Mailing Address - Zip Code:96786-5494
Mailing Address - Country:US
Mailing Address - Phone:360-204-1205
Mailing Address - Fax:
Practice Address - Street 1:118 HAINA CT UNIT 103
Practice Address - Street 2:
Practice Address - City:WAHIAWA
Practice Address - State:HI
Practice Address - Zip Code:96786-5494
Practice Address - Country:US
Practice Address - Phone:360-204-1205
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-07-27
Last Update Date:2024-07-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes146L00000XEmergency Medical Service ProvidersEmergency Medical Technician, Paramedic