Individual provider Active NPI

Lacey Kreisel, PHARMD

  • Pharmacist
  • Harlan, IA
National Provider Identifier
1366099467
Registry record updated Aug 22, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
21014 Issued in IA
Practice address
1812 Chatburn PLZ
Harlan, IA 51537-1980
Phone
(712) 755-2101
NPI assigned
Aug 22, 2019
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2019

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist 183500000X 21014 IA Primary

Addresses

Primary practice location

1812 Chatburn PLZ
Harlan, IA 51537-1980

Mailing address

1812 Chatburn PLZ
Harlan, IA 51537-1980
Phone (712) 755-2101

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
Credentials
Doctor of Pharmacy

State licenses

LicenseStateTypeSpecialty
21014IAMDPharmacist

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1566432000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1566432000000",
    "number": "1366099467",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1812 CHATBURN PLZ",
            "city": "HARLAN",
            "state": "IA",
            "postal_code": "515371980",
            "telephone_number": "712-755-2101"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1812 CHATBURN PLZ",
            "city": "HARLAN",
            "state": "IA",
            "postal_code": "515371980",
            "telephone_number": "712-755-2101"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KREISEL",
        "first_name": "LACEY",
        "credential": "PHARMD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-08-22",
        "last_updated": "2019-08-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "IA",
            "license": "21014",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Harlan, IA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.