Provider Demographics
NPI:1174643100
Name:WURGLER, AUTUMN C (PHARMD)
Entity Type:Individual
Prefix:
First Name:AUTUMN
Middle Name:C
Last Name:WURGLER
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 1:121 S FALL CREEK RD
Mailing Address - Street 2:
Mailing Address - City:PAPILLION
Mailing Address - State:NE
Mailing Address - Zip Code:68133-3342
Mailing Address - Country:US
Mailing Address - Phone:402-898-4632
Mailing Address - Fax:
Practice Address - Street 1:3405 OAK VIEW DR
Practice Address - Street 2:
Practice Address - City:OMAHA
Practice Address - State:NE
Practice Address - Zip Code:68144-5632
Practice Address - Country:US
Practice Address - Phone:402-697-0928
Practice Address - Fax:402-697-1710
Is Sole Proprietor?:No
Enumeration Date:2007-03-31
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE11734183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist