Provider Demographics
NPI:1316378383
Name:SMITH-WOLLNER, SHARON (BSPHARM)
Entity Type:Individual
Prefix:
First Name:SHARON
Middle Name:
Last Name:SMITH-WOLLNER
Suffix:
Gender:F
Credentials:BSPHARM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:210 CHISEL ROCK WAY
Mailing Address - Street 2:
Mailing Address - City:WEAVERVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:28787-7629
Mailing Address - Country:US
Mailing Address - Phone:828-484-9939
Mailing Address - Fax:
Practice Address - Street 1:210 CHISEL ROCK WAY
Practice Address - Street 2:
Practice Address - City:WEAVERVILLE
Practice Address - State:NC
Practice Address - Zip Code:28787-7629
Practice Address - Country:US
Practice Address - Phone:828-484-9939
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-12-02
Last Update Date:2013-12-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC20634183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist