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General NPI Number Information
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NPI Number | 1598380461
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Entity Type | Individual
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Provider Name | JENNA JEAN MANATREY-LANCASTER PHARMD
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Gender | Female
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Dates
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Enumeration Date | 06/16/2020
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Last Update Date | 06/16/2020
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Provider Practice Location Address
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Address Line | 1002 SE NATIONAL DR
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City | ANKENY
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State | IA
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Zip | 50021-3996
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Country | US
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Telephone | 515-963-1111
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Fax |
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Provider Business Mailing Address
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Address Line | 137 CHERRY ST
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City | NORWALK
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State | IA
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Zip | 50211-1687
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Country | US
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Telephone | 515-720-4592
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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 | 183500000X
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Taxonomy Name | Pharmacist
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License Number | 23618
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License Number State | IA
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