Provider Demographics
NPI:1982631396
Name:CHASE, WENDEE LEE (WENDEE)
Entity Type:Individual
Prefix:MRS
First Name:WENDEE
Middle Name:LEE
Last Name:CHASE
Suffix:
Gender:F
Credentials:WENDEE
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:212 S EAST ST
Mailing Address - Street 2:
Mailing Address - City:ROCK RAPIDS
Mailing Address - State:IA
Mailing Address - Zip Code:51246-1754
Mailing Address - Country:US
Mailing Address - Phone:712-472-2727
Mailing Address - Fax:
Practice Address - Street 1:106 N BOONE ST
Practice Address - Street 2:
Practice Address - City:ROCK RAPIDS
Practice Address - State:IA
Practice Address - Zip Code:51246-1537
Practice Address - Country:US
Practice Address - Phone:712-472-4044
Practice Address - Fax:712-472-9617
Is Sole Proprietor?:No
Enumeration Date:2006-06-28
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA18481183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist