Provider Demographics
NPI:1255019436
Name:TEMPEST, ADELAIDE NAEGLE (PHARMD)
Entity type:Individual
Prefix:
First Name:ADELAIDE
Middle Name:NAEGLE
Last Name:TEMPEST
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:
Other - First Name:ADELAIDE
Other - Middle Name:MACKENZIE
Other - Last Name:NAEGLE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PHARMD
Mailing Address - Street 1:4109 S 2000 E
Mailing Address - Street 2:
Mailing Address - City:HOLLADAY
Mailing Address - State:UT
Mailing Address - Zip Code:84124-1702
Mailing Address - Country:US
Mailing Address - Phone:801-882-6205
Mailing Address - Fax:
Practice Address - Street 1:4403 HARRISON BLVD STE 3650
Practice Address - Street 2:
Practice Address - City:OGDEN
Practice Address - State:UT
Practice Address - Zip Code:84403-3288
Practice Address - Country:US
Practice Address - Phone:801-387-7125
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-07-07
Last Update Date:2023-07-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
UT8589909-1701183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist