Provider Demographics
NPI:1790020105
Name:SOLBERG, RACHEL ANN (PHARMD)
Entity Type:Individual
Prefix:
First Name:RACHEL
Middle Name:ANN
Last Name:SOLBERG
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:
Other - First Name:RACHEL
Other - Middle Name:ANN
Other - Last Name:SEXE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:PO BOX 186
Mailing Address - Street 2:
Mailing Address - City:BLAIR
Mailing Address - State:WI
Mailing Address - Zip Code:54616
Mailing Address - Country:US
Mailing Address - Phone:608-989-2919
Mailing Address - Fax:608-989-2837
Practice Address - Street 1:125 WEST BROADWAY
Practice Address - Street 2:
Practice Address - City:BLAIR
Practice Address - State:WI
Practice Address - Zip Code:54616
Practice Address - Country:US
Practice Address - Phone:608-989-2919
Practice Address - Fax:608-989-2837
Is Sole Proprietor?:No
Enumeration Date:2012-12-11
Last Update Date:2015-05-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI16676-40183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist