Provider Demographics
NPI:1629803457
Name:WELLER, ANNE CATHERINE (PHARMD, RPH)
Entity type:Individual
Prefix:
First Name:ANNE
Middle Name:CATHERINE
Last Name:WELLER
Suffix:
Gender:F
Credentials:PHARMD, RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:934 MAIN ST APT 302
Mailing Address - Street 2:
Mailing Address - City:SOUTH WILLIAMSPORT
Mailing Address - State:PA
Mailing Address - Zip Code:17702-7653
Mailing Address - Country:US
Mailing Address - Phone:570-502-5603
Mailing Address - Fax:
Practice Address - Street 1:1321 ALLEGHENY STREET
Practice Address - Street 2:
Practice Address - City:JERSEY SHORE
Practice Address - State:PA
Practice Address - Zip Code:17740
Practice Address - Country:US
Practice Address - Phone:570-398-9861
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-09-03
Last Update Date:2024-09-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PARP458811183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist