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General NPI Number Information
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NPI Number | 1447976733
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Entity Type | Individual
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Provider Name | KIAH WESELI PHARMD
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Gender | Female
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Dates
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Enumeration Date | 10/18/2022
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Last Update Date | 10/16/2024
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Provider Practice Location Address
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Address Line | 4404 WI 70
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City | WEBSTER
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State | WI
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Zip | 54893-8206
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Country | US
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Telephone | 715-866-8644
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Fax |
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Provider Business Mailing Address
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Address Line | 23423 BIRCH RD
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City | SIREN
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State | WI
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Zip | 54872-8440
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Country | US
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Telephone | 763-742-2445
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 183500000X
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Taxonomy Name | Pharmacist
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License Number | 21344-40
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License Number State | WI
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