Provider Demographics
NPI:1528026879
Name:WEFFALD, LINDA ANN (PHARMD)
Entity Type:Individual
Prefix:DR
First Name:LINDA
Middle Name:ANN
Last Name:WEFFALD
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:DR
Other - First Name:LINDA
Other - Middle Name:ANN
Other - Last Name:KEYSER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PHARMD
Mailing Address - Street 1:5555 E ARAPAHOE RD
Mailing Address - Street 2:
Mailing Address - City:CENTENNIAL
Mailing Address - State:CO
Mailing Address - Zip Code:80122-2312
Mailing Address - Country:US
Mailing Address - Phone:303-850-5844
Mailing Address - Fax:303-850-2022
Practice Address - Street 1:5555 E ARAPAHOE RD
Practice Address - Street 2:
Practice Address - City:CENTENNIAL
Practice Address - State:CO
Practice Address - Zip Code:80122-2312
Practice Address - Country:US
Practice Address - Phone:303-850-5844
Practice Address - Fax:303-850-2022
Is Sole Proprietor?:No
Enumeration Date:2006-05-03
Last Update Date:2007-10-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO14108183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist
Provider Identifiers
StateIdentifier IDID TypeIssuer
COC1528026879Medicare PIN