Provider Demographics
NPI:1972851780
Name:WHETSELL, LYNN FELDER (PHARMD)
Entity Type:Individual
Prefix:DR
First Name:LYNN
Middle Name:FELDER
Last Name:WHETSELL
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2195 MAGNOLIA ST
Mailing Address - Street 2:
Mailing Address - City:ORANGEBURG
Mailing Address - State:SC
Mailing Address - Zip Code:29115-4484
Mailing Address - Country:US
Mailing Address - Phone:803-533-1390
Mailing Address - Fax:803-534-7145
Practice Address - Street 1:2195 MAGNOLIA ST
Practice Address - Street 2:
Practice Address - City:ORANGEBURG
Practice Address - State:SC
Practice Address - Zip Code:29115-4484
Practice Address - Country:US
Practice Address - Phone:803-533-1390
Practice Address - Fax:803-534-7145
Is Sole Proprietor?:Yes
Enumeration Date:2012-08-28
Last Update Date:2012-08-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC13364183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist