Provider Demographics
NPI:1750652434
Name:ZUEGE, DARLENE LUELLA
Entity Type:Individual
Prefix:MRS
First Name:DARLENE
Middle Name:LUELLA
Last Name:ZUEGE
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:15823 SPARROWRIDGE CT
Mailing Address - Street 2:
Mailing Address - City:CHARLOTTE
Mailing Address - State:NC
Mailing Address - Zip Code:28278-8844
Mailing Address - Country:US
Mailing Address - Phone:704-504-1376
Mailing Address - Fax:
Practice Address - Street 1:10012 WEISS WAY
Practice Address - Street 2:
Practice Address - City:WAXHAW
Practice Address - State:NC
Practice Address - Zip Code:28173-0800
Practice Address - Country:US
Practice Address - Phone:704-321-2694
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-01-26
Last Update Date:2012-01-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC16665183500000X
IA16610183500000X
IL051036400183500000X
WI1247040183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist