Provider Demographics
NPI:1972635035
Name:BREUER, CHRISTINE A (PHARMD)
Entity type:Individual
Prefix:
First Name:CHRISTINE
Middle Name:A
Last Name:BREUER
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:400 1ST AVE W
Mailing Address - Street 2:
Mailing Address - City:NEWTON
Mailing Address - State:IA
Mailing Address - Zip Code:50208-3001
Mailing Address - Country:US
Mailing Address - Phone:641-792-3528
Mailing Address - Fax:641-792-3526
Practice Address - Street 1:400 1ST AVE W
Practice Address - Street 2:
Practice Address - City:NEWTON
Practice Address - State:IA
Practice Address - Zip Code:50208-3001
Practice Address - Country:US
Practice Address - Phone:641-792-3528
Practice Address - Fax:641-792-3526
Is Sole Proprietor?:No
Enumeration Date:2007-03-12
Last Update Date:2007-07-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA19817183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist
Provider Identifiers
StateIdentifier IDID TypeIssuer
IA19817OtherPHARMACIST LICENSE