Provider Demographics
NPI:1841537610
Name:LANHAM, EDWINA MARLENE (RPH)
Entity type:Individual
Prefix:MS
First Name:EDWINA
Middle Name:MARLENE
Last Name:LANHAM
Suffix:
Gender:F
Credentials:RPH
Other - Prefix:MISS
Other - First Name:EDWINA
Other - Middle Name:MARLENE
Other - Last Name:NICHOLSON
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:RPH
Mailing Address - Street 1:6602 E PHELPS RD
Mailing Address - Street 2:
Mailing Address - City:SCOTTSDALE
Mailing Address - State:AZ
Mailing Address - Zip Code:85254-5659
Mailing Address - Country:US
Mailing Address - Phone:480-991-0962
Mailing Address - Fax:
Practice Address - Street 1:6602 E PHELPS RD
Practice Address - Street 2:
Practice Address - City:SCOTTSDALE
Practice Address - State:AZ
Practice Address - Zip Code:85254-5659
Practice Address - Country:US
Practice Address - Phone:480-991-0962
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-01-13
Last Update Date:2013-01-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZS108731835P0018X
NC202721835P0018X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1835P0018XPharmacy Service ProvidersPharmacistPharmacist Clinician (PhC)/ Clinical Pharmacy Specialist