Provider Demographics
NPI:1861746307
Name:SCHRANK, KIMBERLY JEAN (RPH)
Entity type:Individual
Prefix:MRS
First Name:KIMBERLY
Middle Name:JEAN
Last Name:SCHRANK
Suffix:
Gender:F
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5000 W. CHAMBERS
Mailing Address - Street 2:ROOM 0115
Mailing Address - City:MILWAUKEE
Mailing Address - State:WI
Mailing Address - Zip Code:53210
Mailing Address - Country:US
Mailing Address - Phone:414-874-1026
Mailing Address - Fax:414-874-1099
Practice Address - Street 1:5000 W. CHAMBERS
Practice Address - Street 2:ROOM 0115
Practice Address - City:MILWAUKEE
Practice Address - State:WI
Practice Address - Zip Code:53210
Practice Address - Country:US
Practice Address - Phone:414-874-1026
Practice Address - Fax:414-874-1099
Is Sole Proprietor?:No
Enumeration Date:2012-11-06
Last Update Date:2012-11-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI11653-040183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist
Provider Identifiers
StateIdentifier IDID TypeIssuer
WI339260OtherNABP