Provider Demographics
NPI:1831470392
Name:LEMKE, TERESE MARIE (RPH)
Entity Type:Individual
Prefix:MRS
First Name:TERESE
Middle Name:MARIE
Last Name:LEMKE
Suffix:
Gender:F
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:603 W PINE ST
Mailing Address - Street 2:
Mailing Address - City:BARABOO
Mailing Address - State:WI
Mailing Address - Zip Code:53913-1040
Mailing Address - Country:US
Mailing Address - Phone:608-356-1171
Mailing Address - Fax:608-356-0981
Practice Address - Street 1:603 W PINE ST
Practice Address - Street 2:
Practice Address - City:BARABOO
Practice Address - State:WI
Practice Address - Zip Code:53913-1040
Practice Address - Country:US
Practice Address - Phone:608-356-1171
Practice Address - Fax:608-356-0981
Is Sole Proprietor?:No
Enumeration Date:2011-08-29
Last Update Date:2011-10-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI12082183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist