Provider Demographics
NPI:1114527595
Name:THALMAN, JANEEN RENEE (RPH)
Entity Type:Individual
Prefix:
First Name:JANEEN
Middle Name:RENEE
Last Name:THALMAN
Suffix:
Gender:F
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6294 AUTUMN LEAF DR
Mailing Address - Street 2:
Mailing Address - City:FREDERICKSBURG
Mailing Address - State:VA
Mailing Address - Zip Code:22407-7205
Mailing Address - Country:US
Mailing Address - Phone:540-359-5082
Mailing Address - Fax:
Practice Address - Street 1:125 WASHINGTON SQUARE PLZ
Practice Address - Street 2:
Practice Address - City:FREDERICKSBURG
Practice Address - State:VA
Practice Address - Zip Code:22405-3235
Practice Address - Country:US
Practice Address - Phone:540-899-8951
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-10-27
Last Update Date:2020-10-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0202012469183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist