Provider Demographics
NPI:1316212681
Name:KLUESNER, EMILY (RPH)
Entity type:Individual
Prefix:
First Name:EMILY
Middle Name:
Last Name:KLUESNER
Suffix:
Gender:F
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:659 DUNCAN RD
Mailing Address - Street 2:
Mailing Address - City:NAUVOO
Mailing Address - State:AL
Mailing Address - Zip Code:35578-5767
Mailing Address - Country:US
Mailing Address - Phone:205-384-6238
Mailing Address - Fax:
Practice Address - Street 1:1551 FORESTDALE BLVD
Practice Address - Street 2:
Practice Address - City:FORESTDALE
Practice Address - State:AL
Practice Address - Zip Code:35214-3017
Practice Address - Country:US
Practice Address - Phone:205-798-8360
Practice Address - Fax:205-798-6130
Is Sole Proprietor?:No
Enumeration Date:2012-03-20
Last Update Date:2012-03-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL13672183500000X
MST12413183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist