Provider Demographics
NPI:1083244685
Name:ISIEKWENE, DEBBIE SADE (PHARMD)
Entity Type:Individual
Prefix:
First Name:DEBBIE
Middle Name:SADE
Last Name:ISIEKWENE
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 1:5715 W APPLETON AVE
Mailing Address - Street 2:
Mailing Address - City:MILWAUKEE
Mailing Address - State:WI
Mailing Address - Zip Code:53210-2250
Mailing Address - Country:US
Mailing Address - Phone:414-988-2188
Mailing Address - Fax:
Practice Address - Street 1:5715 W APPLETON AVE
Practice Address - Street 2:
Practice Address - City:MILWAUKEE
Practice Address - State:WI
Practice Address - Zip Code:53210-2250
Practice Address - Country:US
Practice Address - Phone:414-988-2188
Practice Address - Fax:414-988-2187
Is Sole Proprietor?:No
Enumeration Date:2020-01-22
Last Update Date:2020-01-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI1854640183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist