Healthcare Provider Details

I. General information

NPI: 1336805019
Provider Name (Legal Business Name): RHEANNA KIES
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/16/2021
Last Update Date: 05/20/2026
Certification Date: 05/20/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7747 OLD TROY PIKE
HUBER HEIGHTS OH
45424-2085
US

IV. Provider business mailing address

2817 NEW CASTLE DR
TROY OH
45373-4653
US

V. Phone/Fax

Practice location:
  • Phone: 937-233-7680
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1835P0018X
TaxonomyPharmacist Clinician (PhC)/ Clinical Pharmacy Specialist
License Number03441379
License Number StateOH
# 2
Primary TaxonomyN
Taxonomy Code183500000X
TaxonomyPharmacist
License Number03441379
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: