Kyla Celeste Mittanck, RPH

Primary specialty

PharmacistTaxonomy code 183500000X

License

34832 Issued in TX

Practice address

13500 Hwy 36
Needville, TX 77461

Phone

(979) 793-5534

NPI assigned

May 11, 2020

Last updated

May 11, 2020By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Registered Pharmacist

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Pharm House Needville, LLC.

  dba Pharm House Drug - Needville, LLC.

  • Community/Retail Pharmacy
  • Needville, TX
  • NPI 1881192185
  NPD
• Lifechek Rosenberg LLC

  dba Lifechek

  • Community/Retail Pharmacy
  • Needville, TX
  • NPI 1790890994
  NPD (past)

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

{
    "created_epoch": "1589155200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1589155200000",
    "number": "1629690896",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1030",
            "city": "NEEDVILLE",
            "state": "TX",
            "postal_code": "774611030"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "13500 HWY 36",
            "city": "NEEDVILLE",
            "state": "TX",
            "postal_code": "77461",
            "telephone_number": "979-793-5534"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MITTANCK",
        "first_name": "KYLA",
        "middle_name": "CELESTE",
        "credential": "RPH",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-05-11",
        "last_updated": "2020-05-11",
        "certification_date": "2020-05-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "TX",
            "license": "34832",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Lifechek Rosenberg LLC (Lifechek)
• Kaitlyn Massey, LCSW
• Daniel Raymond Matthiesen
• Shana Mignery
• Kathleen Mires, OT
• Mora Cares, Inc
• Yezid Fernando Mora, M.D.
• Moving Mountains, LLC
• Cara L Mularski
• Needville Family Dentistry, PLLC

• Pharmacist in Needville, TX
• Providers in Needville, TX by specialty
• Pharmacist in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 11, 2020; 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.