Provider Demographics
NPI:1528052941
Name:SPINNIKEN, KATHRYN NEUMANN (RPH, CGP, MBA)
Entity type:Individual
Prefix:
First Name:KATHRYN
Middle Name:NEUMANN
Last Name:SPINNIKEN
Suffix:
Gender:F
Credentials:RPH, CGP, MBA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6730 E ALPERS RD
Mailing Address - Street 2:
Mailing Address - City:LAKE LEELANAU
Mailing Address - State:MI
Mailing Address - Zip Code:49653-9634
Mailing Address - Country:US
Mailing Address - Phone:231-271-6696
Mailing Address - Fax:
Practice Address - Street 1:550 MUNSON AVE
Practice Address - Street 2:
Practice Address - City:TRAVERSE CITY
Practice Address - State:MI
Practice Address - Zip Code:49686-3580
Practice Address - Country:US
Practice Address - Phone:231-935-8734
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2005-08-31
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI53020295191835G0303X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1835G0303XPharmacy Service ProvidersPharmacistGeriatric