Provider Demographics
NPI:1366291049
Name:HOCKENBERRY, MARCIA LYNN (PHARMD)
Entity type:Individual
Prefix:
First Name:MARCIA
Middle Name:LYNN
Last Name:HOCKENBERRY
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 1:800 TIMBER LN
Mailing Address - Street 2:
Mailing Address - City:ANITA
Mailing Address - State:IA
Mailing Address - Zip Code:50020-1055
Mailing Address - Country:US
Mailing Address - Phone:712-249-6795
Mailing Address - Fax:
Practice Address - Street 1:1501 E 10TH ST
Practice Address - Street 2:
Practice Address - City:ATLANTIC
Practice Address - State:IA
Practice Address - Zip Code:50022-1936
Practice Address - Country:US
Practice Address - Phone:712-243-7508
Practice Address - Fax:712-435-7074
Is Sole Proprietor?:Yes
Enumeration Date:2024-05-15
Last Update Date:2024-05-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA19264183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist