Provider Demographics
NPI:1548815129
Name:NIMITZ, KAMI ELIZABETH (PHARMD)
Entity type:Individual
Prefix:
First Name:KAMI
Middle Name:ELIZABETH
Last Name:NIMITZ
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:315 N 6TH ST
Mailing Address - Street 2:
Mailing Address - City:KIOWA
Mailing Address - State:KS
Mailing Address - Zip Code:67070-1217
Mailing Address - Country:US
Mailing Address - Phone:580-849-1008
Mailing Address - Fax:
Practice Address - Street 1:530 MAIN ST
Practice Address - Street 2:
Practice Address - City:KIOWA
Practice Address - State:KS
Practice Address - Zip Code:67070-1406
Practice Address - Country:US
Practice Address - Phone:620-825-4782
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-08-09
Last Update Date:2019-08-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS1-109659183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist