Provider Demographics
NPI:1780284877
Name:LICHTENWALNER, JENELLE (PHARMD)
Entity type:Individual
Prefix:DR
First Name:JENELLE
Middle Name:
Last Name:LICHTENWALNER
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:100 E STREET RD
Mailing Address - Street 2:
Mailing Address - City:WARMINSTER
Mailing Address - State:PA
Mailing Address - Zip Code:18974-3400
Mailing Address - Country:US
Mailing Address - Phone:267-544-0600
Mailing Address - Fax:
Practice Address - Street 1:100 E STREET RD
Practice Address - Street 2:
Practice Address - City:WARMINSTER
Practice Address - State:PA
Practice Address - Zip Code:18974-3400
Practice Address - Country:US
Practice Address - Phone:215-442-5608
Practice Address - Fax:215-442-5621
Is Sole Proprietor?:Yes
Enumeration Date:2020-10-28
Last Update Date:2020-10-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PARP442068183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist