Provider Demographics
NPI:1558571406
Name:ZETER, ANNE KNISELY (RPH)
Entity Type:Individual
Prefix:MRS
First Name:ANNE
Middle Name:KNISELY
Last Name:ZETER
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 1:3315 REINA DR NE
Mailing Address - Street 2:
Mailing Address - City:ALBUQUERQUE
Mailing Address - State:NM
Mailing Address - Zip Code:87111-5039
Mailing Address - Country:US
Mailing Address - Phone:505-237-1869
Mailing Address - Fax:
Practice Address - Street 1:12201 ACADEMY RD NE
Practice Address - Street 2:
Practice Address - City:ALBUQUERQUE
Practice Address - State:NM
Practice Address - Zip Code:87111-8051
Practice Address - Country:US
Practice Address - Phone:505-275-9733
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-05-22
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NM4823183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist