Provider Demographics
NPI:1215210265
Name:OLMER, BRANDI ROSE (PHARMD)
Entity Type:Individual
Prefix:MS
First Name:BRANDI
Middle Name:ROSE
Last Name:OLMER
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 1:3123 FLETCHER AVE
Mailing Address - Street 2:APT 245
Mailing Address - City:LINCOLN
Mailing Address - State:NE
Mailing Address - Zip Code:68504-1042
Mailing Address - Country:US
Mailing Address - Phone:402-546-6596
Mailing Address - Fax:
Practice Address - Street 1:1404 SUPERIOR ST
Practice Address - Street 2:
Practice Address - City:LINCOLN
Practice Address - State:NE
Practice Address - Zip Code:68521-1945
Practice Address - Country:US
Practice Address - Phone:402-477-2622
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-09-27
Last Update Date:2013-05-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX50796183500000X
NE13786183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist