Provider Demographics
NPI:1013220169
Name:LOSEY, COLLEEN SUSAN (PHARMD)
Entity Type:Individual
Prefix:
First Name:COLLEEN
Middle Name:SUSAN
Last Name:LOSEY
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:312 9TH ST SW
Mailing Address - Street 2:
Mailing Address - City:WAVERLY
Mailing Address - State:IA
Mailing Address - Zip Code:50677-2999
Mailing Address - Country:US
Mailing Address - Phone:319-352-4958
Mailing Address - Fax:319-483-4168
Practice Address - Street 1:312 9TH ST SW
Practice Address - Street 2:
Practice Address - City:WAVERLY
Practice Address - State:IA
Practice Address - Zip Code:50677-2999
Practice Address - Country:US
Practice Address - Phone:319-352-4958
Practice Address - Fax:319-483-4168
Is Sole Proprietor?:No
Enumeration Date:2010-07-19
Last Update Date:2020-05-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA212291835P0018X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1835P0018XPharmacy Service ProvidersPharmacistPharmacist Clinician (PhC)/ Clinical Pharmacy Specialist