Provider Demographics
NPI:1700208162
Name:WUEST, ELIZABETH ANN (PHARM D)
Entity Type:Individual
Prefix:MS
First Name:ELIZABETH
Middle Name:ANN
Last Name:WUEST
Suffix:
Gender:F
Credentials:PHARM D
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1500 MARTIN LUTHER KING JR PKWY SE
Mailing Address - Street 2:
Mailing Address - City:WILSON
Mailing Address - State:NC
Mailing Address - Zip Code:27893-6524
Mailing Address - Country:US
Mailing Address - Phone:252-237-3185
Mailing Address - Fax:252-243-0537
Practice Address - Street 1:1500 MARTIN LUTHER KING JR PKWY SE
Practice Address - Street 2:
Practice Address - City:WILSON
Practice Address - State:NC
Practice Address - Zip Code:27893-6524
Practice Address - Country:US
Practice Address - Phone:252-237-3185
Practice Address - Fax:252-243-0537
Is Sole Proprietor?:No
Enumeration Date:2014-01-20
Last Update Date:2014-01-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC23902183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist