Healthcare Provider Details

I. General information

NPI: 1134746266
Provider Name (Legal Business Name): ANNA CLAIRE MARCEAU PHARMD
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/06/2020
Last Update Date: 07/06/2020
Certification Date: 07/06/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2500 OVERLOOK TER
MADISON WI
53705-2254
US

IV. Provider business mailing address

8550 GREENWAY BLVD APT 408
MIDDLETON WI
53562-4731
US

V. Phone/Fax

Practice location:
  • Phone: 608-256-1901
  • Fax:
Mailing address:
  • Phone: 563-357-9759
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1835P1300X
TaxonomyPsychiatric Pharmacist
License Number23642
License Number StateIA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: