Provider Demographics
NPI:1265767206
Name:O'NELE, ROBIN SUZETTE (PHARMD)
Entity type:Individual
Prefix:MRS
First Name:ROBIN
Middle Name:SUZETTE
Last Name:O'NELE
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:MISS
Other - First Name:ROBIN
Other - Middle Name:SUZETTE
Other - Last Name:DAVIDSON
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:3656 W DENALI DR
Mailing Address - Street 2:
Mailing Address - City:ANTHEM
Mailing Address - State:AZ
Mailing Address - Zip Code:85086-8027
Mailing Address - Country:US
Mailing Address - Phone:623-476-2314
Mailing Address - Fax:
Practice Address - Street 1:39508 N DAISY MOUNTAIN DR
Practice Address - Street 2:
Practice Address - City:ANTHEM
Practice Address - State:AZ
Practice Address - Zip Code:85086-6056
Practice Address - Country:US
Practice Address - Phone:623-551-7221
Practice Address - Fax:623-551-7220
Is Sole Proprietor?:Yes
Enumeration Date:2009-10-08
Last Update Date:2009-10-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ14246183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist