Provider Demographics
NPI:1023618253
Name:KITZMILLER, SHERI MARIE
Entity type:Individual
Prefix:
First Name:SHERI
Middle Name:MARIE
Last Name:KITZMILLER
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 1:226 SOUTHVIEW RD
Mailing Address - Street 2:
Mailing Address - City:MC DONALD
Mailing Address - State:PA
Mailing Address - Zip Code:15057-2803
Mailing Address - Country:US
Mailing Address - Phone:412-728-7260
Mailing Address - Fax:
Practice Address - Street 1:80 TRINITY POINT DR
Practice Address - Street 2:
Practice Address - City:WASHINGTON
Practice Address - State:PA
Practice Address - Zip Code:15301-2974
Practice Address - Country:US
Practice Address - Phone:724-229-5394
Practice Address - Fax:724-229-5396
Is Sole Proprietor?:Yes
Enumeration Date:2020-10-27
Last Update Date:2020-10-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PARP438954183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes183500000XPharmacy Service ProvidersPharmacistGroup - Single Specialty