Provider Demographics
NPI:1114521218
Name:SPRINGER, EMILY ANNE (PHARMD)
Entity Type:Individual
Prefix:
First Name:EMILY
Middle Name:ANNE
Last Name:SPRINGER
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 1:6119 STELLHORN RD
Mailing Address - Street 2:
Mailing Address - City:FORT WAYNE
Mailing Address - State:IN
Mailing Address - Zip Code:46815-5357
Mailing Address - Country:US
Mailing Address - Phone:260-485-4697
Mailing Address - Fax:260-247-7172
Practice Address - Street 1:6119 STELLHORN RD
Practice Address - Street 2:
Practice Address - City:FORT WAYNE
Practice Address - State:IN
Practice Address - Zip Code:46815-5357
Practice Address - Country:US
Practice Address - Phone:260-485-4697
Practice Address - Fax:260-247-7172
Is Sole Proprietor?:No
Enumeration Date:2020-11-30
Last Update Date:2020-11-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN26029007A183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist