Provider Demographics
NPI:1083211379
Name:RETZER, SHELBY ANN (PHARMD)
Entity Type:Individual
Prefix:
First Name:SHELBY
Middle Name:ANN
Last Name:RETZER
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 1:1900 S MARION RD
Mailing Address - Street 2:
Mailing Address - City:SIOUX FALLS
Mailing Address - State:SD
Mailing Address - Zip Code:57106-3636
Mailing Address - Country:US
Mailing Address - Phone:605-361-3347
Mailing Address - Fax:
Practice Address - Street 1:1900 S MARION RD
Practice Address - Street 2:
Practice Address - City:SIOUX FALLS
Practice Address - State:SD
Practice Address - Zip Code:57106-3636
Practice Address - Country:US
Practice Address - Phone:605-361-3347
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-10-08
Last Update Date:2020-10-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SD6792183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist