Provider Demographics
NPI:1992305411
Name:WUEST, DEBORAH C
Entity type:Individual
Prefix:
First Name:DEBORAH
Middle Name:C
Last Name:WUEST
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5422 S ELK RIVER RD
Mailing Address - Street 2:
Mailing Address - City:RENO
Mailing Address - State:NV
Mailing Address - Zip Code:89511-5653
Mailing Address - Country:US
Mailing Address - Phone:775-843-6463
Mailing Address - Fax:
Practice Address - Street 1:5422 S ELK RIVER RD
Practice Address - Street 2:
Practice Address - City:RENO
Practice Address - State:NV
Practice Address - Zip Code:89511-5653
Practice Address - Country:US
Practice Address - Phone:775-843-6463
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-10-26
Last Update Date:2020-10-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NV10926183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist