Individual
DIANE ADELE MOELLER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RPH
Contact information
Practice address
2200 W KIMBERLY RD, DAVENPORT, IA 52806-5369
(563) 391-1543
Mailing address
3238 CRESTLINE DR, DAVENPORT, IA 52803-3519
(309) 360-4692
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
051039182
IL
183500000X
Pharmacist
11690
KS
183500000X
Pharmacist
Primary
24080
IA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
051039182
ILLINOIS BOARD OF PHARMACY
IL
01
—
11690
KANSAS BOARD OF PHARMACY
KS
Enumeration date
10/28/2020
Last updated
03/14/2026
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