Individual
ALISA SHIELDS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PHARMD
Contact information
Practice address
2801 COMMERCE DR, CORALVILLE, IA 52241-2757
(319) 545-6412
Mailing address
135 CAMBRIDGE WAY, NORTH LIBERTY, IA 52317-8011
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
18462
IA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
18462
IOWA BOARD OF PHARMACY
IA
Enumeration date
09/13/2019
Last updated
09/13/2019
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