Provider Demographics
NPI:1366885873
Name:GLENCER, SHEILA MARIE (PHARMD)
Entity type:Individual
Prefix:
First Name:SHEILA
Middle Name:MARIE
Last Name:GLENCER
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 1:8850 N 83RD AVE
Mailing Address - Street 2:
Mailing Address - City:OMAHA
Mailing Address - State:NE
Mailing Address - Zip Code:68122-2254
Mailing Address - Country:US
Mailing Address - Phone:402-740-5967
Mailing Address - Fax:
Practice Address - Street 1:8850 N 83RD AVE
Practice Address - Street 2:
Practice Address - City:OMAHA
Practice Address - State:NE
Practice Address - Zip Code:68122-2254
Practice Address - Country:US
Practice Address - Phone:402-740-5967
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-04-15
Last Update Date:2013-04-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE10906183500000X
IA18752183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist