Provider Demographics
NPI:1417037144
Name:TERNENT, REBECCA ANN (PHARMD)
Entity Type:Individual
Prefix:
First Name:REBECCA
Middle Name:ANN
Last Name:TERNENT
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 1:11851 LAKEVIEW DR
Mailing Address - Street 2:
Mailing Address - City:CONNEAUT LAKE
Mailing Address - State:PA
Mailing Address - Zip Code:16316-3718
Mailing Address - Country:US
Mailing Address - Phone:814-241-2922
Mailing Address - Fax:
Practice Address - Street 1:740 N MAIN STREET EXT
Practice Address - Street 2:
Practice Address - City:MEADVILLE
Practice Address - State:PA
Practice Address - Zip Code:16335-1149
Practice Address - Country:US
Practice Address - Phone:814-724-3107
Practice Address - Fax:814-724-3108
Is Sole Proprietor?:No
Enumeration Date:2006-10-17
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PARP437849183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist