Provider Demographics
NPI:1467737536
Name:PEMBLETON, ABBIE LYNNE (PHARMD)
Entity Type:Individual
Prefix:MRS
First Name:ABBIE
Middle Name:LYNNE
Last Name:PEMBLETON
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 1:5320 NW 3RD ST
Mailing Address - Street 2:
Mailing Address - City:LINCOLN
Mailing Address - State:NE
Mailing Address - Zip Code:68521-5300
Mailing Address - Country:US
Mailing Address - Phone:402-570-6082
Mailing Address - Fax:
Practice Address - Street 1:1404 SUPERIOR ST
Practice Address - Street 2:
Practice Address - City:LINCOLN
Practice Address - State:NE
Practice Address - Zip Code:68521-1945
Practice Address - Country:US
Practice Address - Phone:402-477-2622
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-10-20
Last Update Date:2011-10-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE13381183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist