Provider Demographics
NPI:1437425485
Name:GWIN, R. DEBORAH (PHARMD)
Entity Type:Individual
Prefix:DR
First Name:R.
Middle Name:DEBORAH
Last Name:GWIN
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 1:2249 SANDPIPER CT N
Mailing Address - Street 2:
Mailing Address - City:WEST LAFAYETTE
Mailing Address - State:IN
Mailing Address - Zip Code:47906-6510
Mailing Address - Country:US
Mailing Address - Phone:765-497-4293
Mailing Address - Fax:
Practice Address - Street 1:2249 SANDPIPER CT N
Practice Address - Street 2:
Practice Address - City:WEST LAFAYETTE
Practice Address - State:IN
Practice Address - Zip Code:47906-6510
Practice Address - Country:US
Practice Address - Phone:765-497-4293
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-03-23
Last Update Date:2012-03-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN26013560A183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist