Sally Suzanne Fullenkamp, PHARM D.

NPI #1124303250 in La Vista, Nebraska

Provider Information

NPI Number: 1124303250
Entity Type: Individual
Name: Sally Suzanne Fullenkamp, PHARM D.
Gender: Not Specified
Sole Proprietor: No
Primary Specialty: Pharmacist
Credential: PHARM D.
Enumeration Date: Oct 20, 2011
Last Updated: Oct 20, 2011

Practice Location

Address: 10314 FLORENCE CIR
City: La Vista
State: Nebraska
ZIP Code: 68128-2372
Phone: (402) 504-9932

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Pharmacist	183500000X	Primary

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