Provider Demographics
NPI:1861492068
Name:BUCKLEY, ELIZABETH ANNE (PHARMD, RPH)
Entity type:Individual
Prefix:DR
First Name:ELIZABETH
Middle Name:ANNE
Last Name:BUCKLEY
Suffix:
Gender:F
Credentials:PHARMD, RPH
Other - Prefix:DR
Other - First Name:ELIZABETH
Other - Middle Name:ANNE
Other - Last Name:MUSIL
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PHARMD, RPH
Mailing Address - Street 1:6234 LINCOLNSHIRE DR
Mailing Address - Street 2:
Mailing Address - City:RACINE
Mailing Address - State:WI
Mailing Address - Zip Code:53403-9734
Mailing Address - Country:US
Mailing Address - Phone:262-553-9308
Mailing Address - Fax:
Practice Address - Street 1:1320 WISCONSIN AVE
Practice Address - Street 2:
Practice Address - City:RACINE
Practice Address - State:WI
Practice Address - Zip Code:53403-1978
Practice Address - Country:US
Practice Address - Phone:262-687-5625
Practice Address - Fax:262-687-5657
Is Sole Proprietor?:No
Enumeration Date:2005-07-28
Last Update Date:2013-05-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI11982-040183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist