Provider Demographics
NPI:1346588241
Name:GARNHART, VANESSA CHRISTINE (PHARMD)
Entity Type:Individual
Prefix:MS
First Name:VANESSA
Middle Name:CHRISTINE
Last Name:GARNHART
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:
Other - First Name:VANESSA
Other - Middle Name:CHRISTINE
Other - Last Name:JOHNSON
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:302 SOUTH GRAND AVENUE
Mailing Address - Street 2:
Mailing Address - City:SUN PRAIRIE
Mailing Address - State:WI
Mailing Address - Zip Code:59590
Mailing Address - Country:US
Mailing Address - Phone:608-837-5949
Mailing Address - Fax:608-825-3253
Practice Address - Street 1:302 S GRAND AVE
Practice Address - Street 2:
Practice Address - City:SUN PRAIRIE
Practice Address - State:WI
Practice Address - Zip Code:53590-9827
Practice Address - Country:US
Practice Address - Phone:608-837-5949
Practice Address - Fax:608-825-3253
Is Sole Proprietor?:No
Enumeration Date:2013-01-28
Last Update Date:2013-01-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI16882-40183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist