Elizabeth M Dewalsche, PHARM.D.
Individual provider Active NPI Pharmacist · Clinton, IA
NPI 1700281995 · NPPES record last updated Aug 24, 2016
Key facts
- NPI
- 1700281995
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Pharmacist 183500000X
- License
- 22312 (IA)
- Practice address
- 1726 N 2ND St
Clinton, IA 52732-2645 - Phone
- (563) 242-0626
- NPI assigned
- Oct 30, 2014
- Sex
- Female
- Sole proprietor
- No
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 |
|---|---|---|---|
| 22312 | IA | MD | Pharmacist |
| 051.297773 | IL | MD | Pharmacist |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pharmacist | 183500000X | 22312 | IA | Yes |
| Pharmacist | 183500000X | 051.297773 | IL |
Addresses
Primary practice location
1726 N 2ND St
Clinton, IA 52732-2645
Mailing address
1726 N 2ND St
Clinton, IA 52732-2645
Phone (563) 242-0626
Other providers in Clinton, IA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Aug 24, 2016. 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.