Provider Demographics
NPI:1407132491
Name:HOFFMEYER, WENDY ANN (PHARMD)
Entity Type:Individual
Prefix:
First Name:WENDY
Middle Name:ANN
Last Name:HOFFMEYER
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:N7834 EDGEWATER CT
Mailing Address - Street 2:
Mailing Address - City:SHERWOOD
Mailing Address - State:WI
Mailing Address - Zip Code:54169-9662
Mailing Address - Country:US
Mailing Address - Phone:920-989-1398
Mailing Address - Fax:920-733-3218
Practice Address - Street 1:3330 E CALUMET ST
Practice Address - Street 2:
Practice Address - City:APPLETON
Practice Address - State:WI
Practice Address - Zip Code:54915-4127
Practice Address - Country:US
Practice Address - Phone:920-733-3016
Practice Address - Fax:920-733-3218
Is Sole Proprietor?:Yes
Enumeration Date:2011-10-23
Last Update Date:2011-10-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI14253-040183500000X
MI5302033348183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist