DR. TRACI LEE CHERNE (NPI# 1811598170) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1811598170 |
| Entity Type | Individual |
| Full Name | DR. TRACI LEE CHERNE |
| Credential | PHARM D |
| Practice Address |
1717 N Shawano St New London WI 54961-9365 |
| Practice Telephone | 9209827906 |
| Mailing Telephone | 9209827906 |
| Enumeration Date | 2020-11-03 |
| Last Update Date | 2020-11-03 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 183500000X | Pharmacist | 12603-40 | WI | Pharmacy Service Providers |
| Street Address |
1717 N SHAWANO ST |
| City | NEW LONDON |
| State | WI |
| Zip Code | 54961-9365 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1720005879 | Wal-mart Stores East Lp | Durable Medical Equipment & Medical Supplies | 1717 N Shawano St, New London, WI 54961-9365 | 2006-07-16 |
| 1083213235 | Ryan Joseph Gardner | Pharmacist | 1717 N Shawano St, New London, WI 54961-9365 | 2020-10-20 |
| 1598364663 | Molly Anne Ciardelli | Pharmacist | 1717 N Shawano St, New London, WI 54961-9365 | 2020-10-20 |
| 1104424563 | James Michael Doolin | Pharmacist | 1717 N Shawano St, New London, WI 54961-9365 | 2020-10-16 |
| 1215535000 | Jami Adamovich | Pharmacist | 1717 N Shawano St, New London, WI 54961-9365 | 2020-10-13 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1407406408 | Cheryl Schneider | Technician | L 56 Northgate Estates, New London, WI 54961 | 2019-09-12 |
| 1861634719 | Rebecca L Kramer | Counselor | 315 Burton St, New London, WI 54961 | 2009-03-24 |
| 1598913501 | Marsha Ann Nytes | Licensed Practical Nurse | E8222 Weyawega Rd, New London, WI 54961 | 2008-09-03 |
| 1659585172 | Amanda L. Beck | Physical Therapy Assistant | 400 E. 4th Street, Manawa, WI 54961 | 2007-05-10 |
| 1366599433 | Griebenow Eyecare, S.c. | Optometrist | 105 Northridge Drive, New London, WI 54961 | 2007-01-04 |
| 1740822055 | Lauren Mae Flunker | Social Worker | E7475 Rawhide Rd, New London, WI 54961 | 2019-10-09 |
| 1063641249 | Forefront Dermatology, S.c. | Dermatology | 1620 N Shawano St, Suite C, New London, WI 54961 | 2009-07-08 |
| 1093982530 | Ascension Medical Group-fox Valley Wisconsin, Inc | Clinic/Center | 1420 Algoma St, New London, WI 54961 | 2008-05-14 |
| 1821263849 | Mark Alan Tegtmeier | Counselor | E7475 Rawhide Rd, New London, WI 54961 | 2008-04-30 |
| 1194910489 | Laurie Mollenhauer | Physical Therapist | 1405 Mill St, New London, WI 54961 | 2007-09-10 |
| Find all providers in zip 54961 | ||||
| Taxonomy Code | 183500000X |
| Grouping | Pharmacy Service Providers |
| Classification | Pharmacist |
| An individual licensed by the appropriate state regulatory agency to engage in the practice of pharmacy. The practice of pharmacy includes, but is not limited to, assessment, interpretation, evaluation, and implementation, initiation, monitoring or modification of medication and or medical orders; the compounding or dispensing of medication and or medical orders; participation in drug and device procurement, storage, and selection; drug administration; drug regimen reviews; drug or drug-related research; provision of patient education and the provision of those acts or services necessary to provide medication therapy management services in all areas of patient care. |
| Notes: Source: Adapted from National Association of Boards of Pharmacy Model State Pharmacy Act, Article 1, Section 104. [1/1/2006: definition modified, source modified] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1295357218 | Glenn L Perreault | Pharmacist | 82 Newport Rd, New London, NH 03257 | 2020-05-13 |
| 1457726358 | Clifford Aguele | Pharmacist | 139 Blydenburg Ave, New London, CT 06320-4809 | 2015-12-03 |
| 1144408014 | Timothy Earl Calder | Pharmacist | 981 N Shawano St, New London, WI 54961-9380 | 2008-02-04 |
| 1730204439 | Daniel A Chase | Pharmacist | E8738 Oakwood Pass, New London, WI 54961-8963 | 2007-03-20 |
| 1457427718 | Joseph A. Thibeault | Pharmacist | 467 Ocean Ave, New London, CT 06320 | 2006-11-28 |
| 1083213235 | Ryan Joseph Gardner | Pharmacist | 1717 N Shawano St, New London, WI 54961-9365 | 2020-10-20 |
| 1598364663 | Molly Anne Ciardelli | Pharmacist | 1717 N Shawano St, New London, WI 54961-9365 | 2020-10-20 |
| 1104424563 | James Michael Doolin | Pharmacist | 1717 N Shawano St, New London, WI 54961-9365 | 2020-10-16 |
| 1215535000 | Jami Adamovich | Pharmacist | 1717 N Shawano St, New London, WI 54961-9365 | 2020-10-13 |
| 1316559461 | Julia Eisenstein | Pharmacist | 817 Bank St, New London, CT 06320-3503 | 2020-08-20 |
| Find all providers in NEW LONDON | ||||
| City | NEW LONDON |
| Zip Code | 54961 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.