Provider Demographics
NPI:1437200011
Name:EXNER, JOAN (RPH)
Entity Type:Individual
Prefix:
First Name:JOAN
Middle Name:
Last Name:EXNER
Suffix:
Gender:F
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2225 CENTRAL AVE
Mailing Address - Street 2:
Mailing Address - City:DUBUQUE
Mailing Address - State:IA
Mailing Address - Zip Code:52001-3506
Mailing Address - Country:US
Mailing Address - Phone:563-588-8704
Mailing Address - Fax:563-588-8759
Practice Address - Street 1:2225 CENTRAL AVE
Practice Address - Street 2:
Practice Address - City:DUBUQUE
Practice Address - State:IA
Practice Address - Zip Code:52001-3506
Practice Address - Country:US
Practice Address - Phone:563-588-8704
Practice Address - Fax:563-588-8759
Is Sole Proprietor?:No
Enumeration Date:2007-01-12
Last Update Date:2010-05-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA18579183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist