Provider Demographics
NPI:1679886493
Name:THORNEWELL, PATRICIA D (PHARMD)
Entity type:Individual
Prefix:
First Name:PATRICIA
Middle Name:D
Last Name:THORNEWELL
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2601 W BELTLINE HWY
Mailing Address - Street 2:STE 600
Mailing Address - City:MADISON
Mailing Address - State:WI
Mailing Address - Zip Code:53713-2316
Mailing Address - Country:US
Mailing Address - Phone:608-729-1598
Mailing Address - Fax:608-729-2598
Practice Address - Street 1:5801 RESEARCH PARK BLVD
Practice Address - Street 2:
Practice Address - City:MADISON
Practice Address - State:WI
Practice Address - Zip Code:53719
Practice Address - Country:US
Practice Address - Phone:608-800-6678
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-07-21
Last Update Date:2019-04-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ORRPH-0012314183500000X
WI15999-40183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist