Provider Demographics
NPI:1083005433
Name:KRUMMICK, CINDY
Entity Type:Individual
Prefix:
First Name:CINDY
Middle Name:
Last Name:KRUMMICK
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1940 S KOELLER ST
Mailing Address - Street 2:
Mailing Address - City:OSHKOSH
Mailing Address - State:WI
Mailing Address - Zip Code:54902-6200
Mailing Address - Country:US
Mailing Address - Phone:920-236-9494
Mailing Address - Fax:920-236-8876
Practice Address - Street 1:1940 S KOELLER ST
Practice Address - Street 2:
Practice Address - City:OSHKOSH
Practice Address - State:WI
Practice Address - Zip Code:54902-6200
Practice Address - Country:US
Practice Address - Phone:920-236-9494
Practice Address - Fax:920-236-8876
Is Sole Proprietor?:No
Enumeration Date:2015-02-06
Last Update Date:2015-02-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI14781-40183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist