Provider Demographics
NPI:1528666260
Name:FOCKEN, DELORES ANITA (PHARMD)
Entity type:Individual
Prefix:DR
First Name:DELORES
Middle Name:ANITA
Last Name:FOCKEN
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:
Other - First Name:DELORES
Other - Middle Name:ANITA
Other - Last Name:BROWN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:5020 N 27TH ST
Mailing Address - Street 2:
Mailing Address - City:LINCOLN
Mailing Address - State:NE
Mailing Address - Zip Code:68521-4738
Mailing Address - Country:US
Mailing Address - Phone:402-477-5099
Mailing Address - Fax:
Practice Address - Street 1:5020 N 27TH ST
Practice Address - Street 2:
Practice Address - City:LINCOLN
Practice Address - State:NE
Practice Address - Zip Code:68521-4738
Practice Address - Country:US
Practice Address - Phone:402-477-5099
Practice Address - Fax:402-477-3921
Is Sole Proprietor?:No
Enumeration Date:2020-10-14
Last Update Date:2020-10-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE16554183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist