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General NPI Number Information
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NPI Number | 1629946835
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Entity Type | Individual
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Provider Name | ANGELA HOMMERDING
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Gender |
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Dates
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Enumeration Date | 10/28/2025
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Last Update Date | 10/28/2025
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Provider Practice Location Address
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Address Line | 2500 E CAPITOL DR
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City | APPLETON
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State | WI
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Zip | 54911-8735
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Country | US
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Telephone | 920-364-3600
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Fax |
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Provider Business Mailing Address
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Address Line | 1083 PENDLETON PKWY UNIT 114
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City | NEENAH
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State | WI
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Zip | 54956-6441
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Country | US
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Telephone |
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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 | 1835P1200X
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Taxonomy Name | Pharmacotherapy Pharmacist
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License Number | 14128-40
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License Number State | WI
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Taxonomy #2
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Taxonomy Code | 1835X0200X
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Taxonomy Name | Oncology Pharmacist
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License Number | 14128-40
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License Number State | WI
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Taxonomy #3
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Taxonomy Code | 183500000X
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Taxonomy Name | Pharmacist
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License Number | 14128-40
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License Number State | WI
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