Rebecca J Ahlborn, PHARMD
Individual provider Active NPI Pharmacist · Appleton, WI
NPI 1720364789 · NPPES record last updated Oct 22, 2011
Key facts
- NPI
- 1720364789
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Pharmacist 183500000X
- License
- 15315-40 (WI)
- Practice address
- 729 W Northland Ave
Appleton, WI 54914-1426 - Phone
- (920) 954-8100
- NPI assigned
- Oct 22, 2011
- Sex
- Female
- Sole proprietor
- Yes
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 |
|---|---|---|---|
| 15315-40 | WI | 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 | 15315-40 | WI | Yes |
Addresses
Primary practice location
729 W Northland Ave
Appleton, WI 54914-1426
Mailing address
729 W Northland Ave
Appleton, WI 54914-1426
Phone (920) 954-8100
Other providers in Appleton, WI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Oct 22, 2011. 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.