Provider Demographics
NPI:1154646255
Name:APPLEBAUGH, JEAN N (PHARM D)
Entity type:Individual
Prefix:
First Name:JEAN
Middle Name:N
Last Name:APPLEBAUGH
Suffix:
Gender:F
Credentials:PHARM D
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1808 W BELTLINE HWY
Mailing Address - Street 2:
Mailing Address - City:MADISON
Mailing Address - State:WI
Mailing Address - Zip Code:53713-2334
Mailing Address - Country:US
Mailing Address - Phone:608-250-1408
Mailing Address - Fax:608-250-1463
Practice Address - Street 1:700 S PARK ST
Practice Address - Street 2:SUITE 300
Practice Address - City:MADISON
Practice Address - State:WI
Practice Address - Zip Code:53715-1830
Practice Address - Country:US
Practice Address - Phone:608-825-6646
Practice Address - Fax:608-256-6460
Is Sole Proprietor?:No
Enumeration Date:2010-03-31
Last Update Date:2011-08-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI14998-040183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist