Provider Demographics
NPI:1457637431
Name:EHLERS, VICKI L (RPH)
Entity Type:Individual
Prefix:MRS
First Name:VICKI
Middle Name:L
Last Name:EHLERS
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 1:3985 S GREENLAWN TER
Mailing Address - Street 2:
Mailing Address - City:NEW BERLIN
Mailing Address - State:WI
Mailing Address - Zip Code:53151-6178
Mailing Address - Country:US
Mailing Address - Phone:262-821-1089
Mailing Address - Fax:
Practice Address - Street 1:2985 S CHICAGO AVE
Practice Address - Street 2:
Practice Address - City:SOUTH MILWAUKEE
Practice Address - State:WI
Practice Address - Zip Code:53172-3133
Practice Address - Country:US
Practice Address - Phone:414-762-9653
Practice Address - Fax:
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
WI11437183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist