Provider Demographics
NPI:1184947624
Name:VARTANIAN, ANNELESA (RPH)
Entity type:Individual
Prefix:MISS
First Name:ANNELESA
Middle Name:
Last Name:VARTANIAN
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 1:743 S LEMAY AVE
Mailing Address - Street 2:
Mailing Address - City:FORT COLLINS
Mailing Address - State:CO
Mailing Address - Zip Code:80524-3251
Mailing Address - Country:US
Mailing Address - Phone:970-482-5492
Mailing Address - Fax:970-482-2063
Practice Address - Street 1:743 S LEMAY AVE
Practice Address - Street 2:
Practice Address - City:FORT COLLINS
Practice Address - State:CO
Practice Address - Zip Code:80524-3251
Practice Address - Country:US
Practice Address - Phone:970-482-5492
Practice Address - Fax:970-482-2063
Is Sole Proprietor?:No
Enumeration Date:2010-03-11
Last Update Date:2025-08-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY052892183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist