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NPI Code Detail

MEDICARE: NANCY KORENKE R.PH.

MEDICARE: NANCY KORENKE R.PH.
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1183500000XPharmacist1852WY

General Provider Information

NPI Number : 1669469466
Entity Type Code : Individual
Provider Name (Legal Business Name) : NANCY KORENKE R.PH.
Provider Business Mailing Address
First Line : 4255 CY AVE
Second Line :
City : CASPER
State : WY
Zip : 82604-4247
Country : US
Telephone Number : 307-232-9605
Fax Number : 307-232-9607
Provider Business Practice Location Address
First Line : 4255 CY AVE
Second Line :
City : CASPER
State : WY
Zip : 82604-4247
Country : US
Telephone Number : 307-232-9605
Fax Number : 307-232-9607
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 10/05/2005
Last Update Date : 10/01/2014

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Directions to “ NANCY KORENKE R.PH.” Practice Location

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