Healthcare Provider Details

I. General information

NPI: 1811813694
Provider Name (Legal Business Name): LISA NEISES RPH
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/26/2026
Last Update Date: 06/26/2026
Certification Date: 06/26/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1201 W AGENCY RD
WEST BURLINGTON IA
52655-1660
US

IV. Provider business mailing address

1201 W AGENCY RD
WEST BURLINGTON IA
52655-1660
US

V. Phone/Fax

Practice location:
  • Phone: 319-753-3681
  • Fax:
Mailing address:
  • Phone: 319-753-3681
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License Number17652
License Number StateIA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: