Provider Demographics
NPI:1457681595
Name:KOENEKE, EMILY ANN SCHULZE (PHARMD)
Entity Type:Individual
Prefix:
First Name:EMILY
Middle Name:ANN SCHULZE
Last Name:KOENEKE
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:CMR 402 BOX 2090
Mailing Address - Street 2:
Mailing Address - City:APO
Mailing Address - State:AE
Mailing Address - Zip Code:09180-2090
Mailing Address - Country:US
Mailing Address - Phone:919-745-9921
Mailing Address - Fax:
Practice Address - Street 1:CMR 402 LANDSTUHL REGIONAL MEDICAL CENTER
Practice Address - Street 2:
Practice Address - City:APO
Practice Address - State:AE
Practice Address - Zip Code:09180
Practice Address - Country:US
Practice Address - Phone:01149637-186-7570
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-01-13
Last Update Date:2012-05-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAPH60102055183500000X
CO19289183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist