Jennifer Niemeyer, PHARM D
Individual provider Active NPI Pharmacist · Lake Station, IN
NPI 1366053357 · NPPES record last updated Aug 12, 2020
Key facts
- NPI
- 1366053357
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Pharmacist 183500000X
- License
- 26020492A (IN)
- Practice address
- 3500 Central Ave
Lake Station, IN 46405-2271 - Phone
- (219) 963-7355
- NPI assigned
- Aug 12, 2020
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 2
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
- Credentials
- Doctor of Pharmacy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 26020492A | IN | MD | Pharmacist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Walgreen Co | Past |
Accepting new patients | |
| Walgreen Co | Past |
Accepting new patients |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pharmacist | 183500000X | 26020492A | IN | Yes |
Addresses
Primary practice location
3500 Central Ave
Lake Station, IN 46405-2271
Mailing address
3500 Central Ave
Lake Station, IN 46405-2271
Phone (219) 963-7355
Other providers in Lake Station, IN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Aug 12, 2020. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.