Provider Demographics
NPI:1790473429
Name:WESTENBERGER, ALYSSA MARIE (PHARMD)
Entity Type:Individual
Prefix:DR
First Name:ALYSSA
Middle Name:MARIE
Last Name:WESTENBERGER
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:DR
Other - First Name:ALYSSA
Other - Middle Name:MARIE
Other - Last Name:ROTE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PHARMD
Mailing Address - Street 1:3937 VOGEL RD
Mailing Address - Street 2:
Mailing Address - City:ARNOLD
Mailing Address - State:MO
Mailing Address - Zip Code:63010-3798
Mailing Address - Country:US
Mailing Address - Phone:636-282-7068
Mailing Address - Fax:636-282-7032
Practice Address - Street 1:1101 W LIBERTY ST
Practice Address - Street 2:
Practice Address - City:FARMINGTON
Practice Address - State:MO
Practice Address - Zip Code:63640-1921
Practice Address - Country:US
Practice Address - Phone:573-760-8061
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-05-01
Last Update Date:2023-05-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2014026880183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist