Basic Information
| Provider Information | |||||||||
| NPI: | 1396101408 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | EISENBIEGLER | ||||||||
| FirstName: | KAREN | ||||||||
| MiddleName: | LYNNE | ||||||||
| NamePrefix: | DR. | ||||||||
| NameSuffix: | |||||||||
| Credential: | PHARMD | ||||||||
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| Mailing Information | |||||||||
| Address1: | PO BOX 10 | ||||||||
| Address2: | |||||||||
| City: | PINON | ||||||||
| State: | AZ | ||||||||
| PostalCode: | 865100010 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9287259514 | ||||||||
| FaxNumber: | 9287259542 | ||||||||
| Practice Location | |||||||||
| Address1: | NAVAJO ROUTE 4 | ||||||||
| Address2: | 2 MILES EAST OF PINON | ||||||||
| City: | PINON | ||||||||
| State: | AZ | ||||||||
| PostalCode: | 865100010 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9287259514 | ||||||||
| FaxNumber: | 9287259542 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 01/05/2016 | ||||||||
| LastUpdateDate: | 12/02/2021 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | Y | ||||||||
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| NPICertificationDate: | 12/02/2021 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 1835P2201X | 033.0003831 | VT | N | 1835P2201X | S025610 | AZ | Y |
No ID Information.