Provider Demographics
NPI:1114146578
Name:DUNPHY, CARMEN J (PHARMD)
Entity Type:Individual
Prefix:
First Name:CARMEN
Middle Name:J
Last Name:DUNPHY
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 1:25 WESTFIELD AVE
Mailing Address - Street 2:UNIT 4
Mailing Address - City:WATERLOO
Mailing Address - State:IA
Mailing Address - Zip Code:50701-5322
Mailing Address - Country:US
Mailing Address - Phone:319-290-7018
Mailing Address - Fax:319-236-0074
Practice Address - Street 1:4000 UNIVERSITY AVE
Practice Address - Street 2:
Practice Address - City:WATERLOO
Practice Address - State:IA
Practice Address - Zip Code:50701-5640
Practice Address - Country:US
Practice Address - Phone:319-236-1786
Practice Address - Fax:319-236-0074
Is Sole Proprietor?:No
Enumeration Date:2007-04-24
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA20078183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist