Provider Demographics
NPI:1093039752
Name:BAEBLER, AMANDA CHRISTINE (PHARMD)
Entity Type:Individual
Prefix:DR
First Name:AMANDA
Middle Name:CHRISTINE
Last Name:BAEBLER
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 1:3182 WILLOW BEND DR
Mailing Address - Street 2:
Mailing Address - City:SAINT CHARLES
Mailing Address - State:MO
Mailing Address - Zip Code:63303-6538
Mailing Address - Country:US
Mailing Address - Phone:618-830-0417
Mailing Address - Fax:
Practice Address - Street 1:11978 SAINT CHARLES ROCK RD
Practice Address - Street 2:
Practice Address - City:BRIDGETON
Practice Address - State:MO
Practice Address - Zip Code:63044-2636
Practice Address - Country:US
Practice Address - Phone:314-291-2290
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-03-23
Last Update Date:2010-03-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2006025357183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist