Provider Demographics
NPI:1750667317
Name:TENNIE, VERONICA ANN (PHARMACIST)
Entity Type:Individual
Prefix:MRS
First Name:VERONICA
Middle Name:ANN
Last Name:TENNIE
Suffix:
Gender:F
Credentials:PHARMACIST
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:1191 WESTOWNE DR
Mailing Address - Street 2:
Mailing Address - City:NEENAH
Mailing Address - State:WI
Mailing Address - Zip Code:54956-2176
Mailing Address - Country:US
Mailing Address - Phone:920-725-3152
Mailing Address - Fax:920-722-3197
Practice Address - Street 1:1191 WESTOWNE DR
Practice Address - Street 2:
Practice Address - City:NEENAH
Practice Address - State:WI
Practice Address - Zip Code:54956-2176
Practice Address - Country:US
Practice Address - Phone:920-725-3152
Practice Address - Fax:920-722-3197
Is Sole Proprietor?:No
Enumeration Date:2011-10-27
Last Update Date:2021-09-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI11735-40183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist