Provider Demographics
NPI:1225335052
Name:CLARKE, CHERYL LINN (RPH)
Entity Type:Individual
Prefix:PROF
First Name:CHERYL
Middle Name:LINN
Last Name:CLARKE
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 1:2507 UNIVERSITY AVE
Mailing Address - Street 2:
Mailing Address - City:DES MOINES
Mailing Address - State:IA
Mailing Address - Zip Code:50311-4516
Mailing Address - Country:US
Mailing Address - Phone:515-271-3899
Mailing Address - Fax:515-271-4569
Practice Address - Street 1:5900 E UNIVERSITY AVE
Practice Address - Street 2:STE 100
Practice Address - City:PLEASANT HILL
Practice Address - State:IA
Practice Address - Zip Code:50327-8457
Practice Address - Country:US
Practice Address - Phone:515-643-2400
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-02-14
Last Update Date:2011-02-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IAB16734183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist