Healthcare Provider Details

I. General information

NPI: 1063657815
Provider Name (Legal Business Name): KATHRYN LOUVEDA KISER PHARM.D., BCPS
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/09/2008
Last Update Date: 12/09/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

16 S EUTAW ST 2ND FLOOR
BALTIMORE MD
21201-1606
US

IV. Provider business mailing address

20 N PINE ST ROOM 444
BALTIMORE MD
21201-1142
US

V. Phone/Fax

Practice location:
  • Phone: 410-328-6779
  • Fax: 410-328-0648
Mailing address:
  • Phone: 410-706-5821
  • Fax: 410-706-4158

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code1835P0018X
TaxonomyPharmacist Clinician (PhC)/ Clinical Pharmacy Specialist
License Number18890
License Number StateMD
# 2
Primary TaxonomyY
Taxonomy Code1835P1200X
TaxonomyPharmacotherapy Pharmacist
License Number18890
License Number StateMD

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: