Provider Demographics
NPI:1194847368
Name:MESSNER HENNIG, ADELE CHRISTINE (RPH)
Entity Type:Individual
Prefix:
First Name:ADELE
Middle Name:CHRISTINE
Last Name:MESSNER HENNIG
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 1:10697 S DEL RIO
Mailing Address - Street 2:
Mailing Address - City:YUMA
Mailing Address - State:AZ
Mailing Address - Zip Code:85367-9006
Mailing Address - Country:US
Mailing Address - Phone:928-342-0684
Mailing Address - Fax:
Practice Address - Street 1:11274 S FORTUNA RD
Practice Address - Street 2:
Practice Address - City:YUMA
Practice Address - State:AZ
Practice Address - Zip Code:85367-7847
Practice Address - Country:US
Practice Address - Phone:928-342-1332
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-06
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ9754183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist