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General NPI Number Information
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NPI Number | 1164826889
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Entity Type | Individual
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Provider Name | RENAE BOERNEKE PHARMD
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Gender | Female
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Dates
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Enumeration Date | 10/09/2014
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Last Update Date | 07/07/2018
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Provider Practice Location Address
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Address Line | 101 MANNING DR
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City | CHAPEL HILL
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State | NC
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Zip | 27514
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Country | US
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Telephone | 559-972-0169
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Fax |
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Provider Business Mailing Address
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Address Line | 1002 DAWES ST
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City | CHAPEL HILL
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State | NC
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Zip | 27516-3008
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Country | US
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Telephone | 559-972-0169
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1835P0018X
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Taxonomy Name | Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist
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License Number | 26737
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License Number State | NC
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Taxonomy #2
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Taxonomy Code | 183500000X
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Taxonomy Name | Pharmacist
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License Number | 71767
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License Number State | CA
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