Provider Demographics
NPI:1366866972
Name:NIEWOEHNER, JULIE ANN (PHARMD)
Entity Type:Individual
Prefix:
First Name:JULIE
Middle Name:ANN
Last Name:NIEWOEHNER
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:
Other - First Name:JULIE
Other - Middle Name:ANN
Other - Last Name:NELSON
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PHARMD
Mailing Address - Street 1:2415 MASSACHUSETTS ST
Mailing Address - Street 2:
Mailing Address - City:LAWRENCE
Mailing Address - State:KS
Mailing Address - Zip Code:66046-4808
Mailing Address - Country:US
Mailing Address - Phone:785-832-4818
Mailing Address - Fax:785-832-4878
Practice Address - Street 1:2415 MASSACHUSETTS ST
Practice Address - Street 2:
Practice Address - City:LAWRENCE
Practice Address - State:KS
Practice Address - Zip Code:66046
Practice Address - Country:US
Practice Address - Phone:785-832-4818
Practice Address - Fax:785-832-4878
Is Sole Proprietor?:No
Enumeration Date:2014-02-18
Last Update Date:2018-09-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SD6064183500000X
OK172501835P0018X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist
No1835P0018XPharmacy Service ProvidersPharmacistPharmacist Clinician (PhC)/ Clinical Pharmacy Specialist