Provider Demographics
NPI:1679065502
Name:IHNKEN, LUANN (RPH)
Entity Type:Individual
Prefix:
First Name:LUANN
Middle Name:
Last Name:IHNKEN
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 1:507 CHESTNUT ST
Mailing Address - Street 2:
Mailing Address - City:ATLANTIC
Mailing Address - State:IA
Mailing Address - Zip Code:50022-1260
Mailing Address - Country:US
Mailing Address - Phone:712-250-4547
Mailing Address - Fax:712-243-2209
Practice Address - Street 1:507 CHESTNUT ST
Practice Address - Street 2:
Practice Address - City:ATLANTIC
Practice Address - State:IA
Practice Address - Zip Code:50022-1260
Practice Address - Country:US
Practice Address - Phone:712-250-4547
Practice Address - Fax:712-243-2209
Is Sole Proprietor?:No
Enumeration Date:2018-06-06
Last Update Date:2018-06-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA177681835P2201X, 183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist
No1835P2201XPharmacy Service ProvidersPharmacistAmbulatory Care