Jenna Marie Wieberg, PHARMD

Primary specialty

Pharmacist Clinician (PhC)/ Clinical Pharmacy SpecialistTaxonomy code 1835P0018X

License

2019030641 Issued in MO

Practice address

30 Lakeview Dr
Camdenton, MO 65020-7108

Phone

(573) 317-9660

NPI assigned

Jul 17, 2023

Sex

Female

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Doctor of Pharmacy

State licenses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1689552000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1689552000000",
    "number": "1538848304",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "169 BROWN RD",
            "city": "TUSCUMBIA",
            "state": "MO",
            "postal_code": "650822312",
            "telephone_number": "573-821-3822"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "30 LAKEVIEW DR",
            "city": "CAMDENTON",
            "state": "MO",
            "postal_code": "650207108",
            "telephone_number": "573-317-9660"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WIEBERG",
        "first_name": "JENNA",
        "middle_name": "MARIE",
        "name_prefix": "Dr.",
        "credential": "PHARMD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-07-17",
        "last_updated": "2023-07-17",
        "certification_date": "2023-07-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1835P0018X",
            "taxonomy_group": "",
            "desc": "Pharmacist, Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist",
            "state": "MO",
            "license": "2019030641",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Alan Craig Wallace, DDS
• Charles Milton Waller, D.D.S.
• Vicki L Waring, DDS
• McKayla Wheeler, HIS
• Jessica Ann Whitworth, NP-C
• Wilkinson Pharmacy, Inc
• Cassidy Brooke Williams, SLP-A
• Matthew Wohl, LMSW

• Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist in Camdenton, MO
• Providers in Camdenton, MO by specialty
• Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist in Missouri

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 17, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.