Healthcare Provider Details

I. General information

NPI: 1891314985
Provider Name (Legal Business Name): VALERIE ANN GLODOWSKI PHARMD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/09/2020
Last Update Date: 04/09/2020
Certification Date: 04/09/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

700 W WISCONSIN AVE
APPLETON WI
54914-3511
US

IV. Provider business mailing address

508 3RD ST
STEVENS POINT WI
54481-1703
US

V. Phone/Fax

Practice location:
  • Phone: 920-991-1190
  • Fax:
Mailing address:
  • Phone: 715-340-5211
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License Number17761-40
License Number StateWI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: