Provider Demographics
NPI:1942825401
Name:BEITZEL, JANE MARIE (RPH)
Entity Type:Individual
Prefix:
First Name:JANE
Middle Name:MARIE
Last Name:BEITZEL
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 1:18206 MEADOW VIEW DR
Mailing Address - Street 2:
Mailing Address - City:DURANGO
Mailing Address - State:IA
Mailing Address - Zip Code:52039-9769
Mailing Address - Country:US
Mailing Address - Phone:563-599-2737
Mailing Address - Fax:
Practice Address - Street 1:157 LOCUST ST
Practice Address - Street 2:
Practice Address - City:DUBUQUE
Practice Address - State:IA
Practice Address - Zip Code:52001-7660
Practice Address - Country:US
Practice Address - Phone:563-588-8702
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-06-10
Last Update Date:2023-11-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA17425183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist