Provider Demographics
NPI:1669135604
Name:GLASHEEN, SARAH (PHARMD)
Entity type:Individual
Prefix:
First Name:SARAH
Middle Name:
Last Name:GLASHEEN
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:
Other - First Name:SARAH
Other - Middle Name:
Other - Last Name:CONJURSKE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:N1470 KEIMAR CT
Mailing Address - Street 2:
Mailing Address - City:GREENVILLE
Mailing Address - State:WI
Mailing Address - Zip Code:54942-8655
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:3330 E CALUMET ST
Practice Address - Street 2:
Practice Address - City:APPLETON
Practice Address - State:WI
Practice Address - Zip Code:54915-4127
Practice Address - Country:US
Practice Address - Phone:920-733-3016
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-10-18
Last Update Date:2024-06-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI21111-40183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist