Active NPI
Lynne Howell Wahlquist
- Pharmacist
- Bristol, FL
National Provider Identifier
1093886020
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- PS20151
- Practice address
- 11049 NW State Rd 20
Bristol, FL 32321 - Phone
- (850) 643-5454
- Fax
- (850) 643-5573
- NPI assigned
- Nov 13, 2006
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pharmacist | 183500000X | PS20151 | FL | Primary |
Addresses
Primary practice location
11049 NW State Rd 20
Bristol, FL 32321
Mailing address
11049 NW State Rd 20
P.O.Box 596
Bristol, FL 32321
Phone (850) 643-5454
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| PS20151 | FL | MD | Pharmacist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1163376000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1093886020",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "11049 NW STATE RD 20",
"address_2": "P.O.BOX 596",
"city": "BRISTOL",
"state": "FL",
"postal_code": "32321",
"telephone_number": "850-643-5454",
"fax_number": "850-643-5573"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "11049 NW STATE RD 20",
"city": "BRISTOL",
"state": "FL",
"postal_code": "32321",
"telephone_number": "850-643-5454",
"fax_number": "850-643-5573"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WAHLQUIST",
"first_name": "LYNNE",
"middle_name": "HOWELL",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2006-11-13",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "FL",
"license": "PS20151",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Bristol, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.