Provider Demographics
NPI:1902437767
Name:BECHER, KARLY (PHARMD/MBA)
Entity Type:Individual
Prefix:
First Name:KARLY
Middle Name:
Last Name:BECHER
Suffix:
Gender:F
Credentials:PHARMD/MBA
Other - Prefix:
Other - First Name:KARLY
Other - Middle Name:
Other - Last Name:GRETTENBERG
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:135 JACKSON ST
Mailing Address - Street 2:
Mailing Address - City:OSHKOSH
Mailing Address - State:WI
Mailing Address - Zip Code:54901-4713
Mailing Address - Country:US
Mailing Address - Phone:920-303-8140
Mailing Address - Fax:920-303-8141
Practice Address - Street 1:135 JACKSON ST
Practice Address - Street 2:
Practice Address - City:OSHKOSH
Practice Address - State:WI
Practice Address - Zip Code:54901-4713
Practice Address - Country:US
Practice Address - Phone:920-303-8140
Practice Address - Fax:920-303-8141
Is Sole Proprietor?:No
Enumeration Date:2020-01-30
Last Update Date:2020-01-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI18465-40183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist