Provider Demographics
NPI:1083103550
Name:ALEMAN, TERESA JESUS (PHARMD)
Entity Type:Individual
Prefix:
First Name:TERESA
Middle Name:JESUS
Last Name:ALEMAN
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:
Other - First Name:TERESA
Other - Middle Name:JESUS
Other - Last Name:GARCIA
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:545 W NUGGET TRL
Mailing Address - Street 2:
Mailing Address - City:FLAGSTAFF
Mailing Address - State:AZ
Mailing Address - Zip Code:86005-6824
Mailing Address - Country:US
Mailing Address - Phone:928-261-6648
Mailing Address - Fax:
Practice Address - Street 1:2920 N 4TH ST
Practice Address - Street 2:
Practice Address - City:FLAGSTAFF
Practice Address - State:AZ
Practice Address - Zip Code:86004-1816
Practice Address - Country:US
Practice Address - Phone:928-522-9403
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-05-09
Last Update Date:2018-05-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZS022226183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist