Healthcare Provider Details

I. General information

NPI: 1003146259
Provider Name (Legal Business Name): JENNIFER I ZUEHLKE PHARMD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/11/2010
Last Update Date: 01/11/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2345 E BASELINE RD
GILBERT AZ
85234-2326
US

IV. Provider business mailing address

2345 E BASELINE RD
GILBERT AZ
85234-2326
US

V. Phone/Fax

Practice location:
  • Phone: 480-892-4978
  • Fax:
Mailing address:
  • Phone: 480-892-4978
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License NumberS016205
License Number StateAZ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: