Provider Demographics
NPI:1073691622
Name:RANER, SHAUNA TERESA (PHARMD)
Entity Type:Individual
Prefix:MRS
First Name:SHAUNA
Middle Name:TERESA
Last Name:RANER
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:MS
Other - First Name:SHAUNA
Other - Middle Name:TERESA
Other - Last Name:HICKEY
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PHARMD
Mailing Address - Street 1:655 LIBERTY WAY
Mailing Address - Street 2:SUITE 3
Mailing Address - City:NORTH LIBERTY
Mailing Address - State:IA
Mailing Address - Zip Code:52317-9154
Mailing Address - Country:US
Mailing Address - Phone:888-823-0923
Mailing Address - Fax:563-324-3305
Practice Address - Street 1:655 LIBERTY WAY
Practice Address - Street 2:SUITE 3
Practice Address - City:NORTH LIBERTY
Practice Address - State:IA
Practice Address - Zip Code:52317-9154
Practice Address - Country:US
Practice Address - Phone:888-823-0923
Practice Address - Fax:563-324-3305
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-01
Last Update Date:2015-06-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA20453183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist