Individual
ERIKA JANEMARIE WANNER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
900 N 6TH ST, BLYTHEVILLE, AR 72315-1702
(870) 763-4507
(870) 762-0782
Mailing address
622 KOSER DR, MARION, AR 72364-2671
(859) 552-7910
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
0000034124
TN
183500000X
Pharmacist
Primary
C14504
AR
183500000X
Pharmacist
E-010556
MS
183500000X
Pharmacist
PST.020993
LA
Other
Enumeration date
12/07/2020
Last updated
12/07/2020
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