Provider Demographics
NPI:1235800996
Name:KASHEF, NESSREEN
Entity Type:Individual
Prefix:
First Name:NESSREEN
Middle Name:
Last Name:KASHEF
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 1:3838 N MARYLAND AVE
Mailing Address - Street 2:
Mailing Address - City:SHOREWOOD
Mailing Address - State:WI
Mailing Address - Zip Code:53211-2430
Mailing Address - Country:US
Mailing Address - Phone:414-378-4234
Mailing Address - Fax:
Practice Address - Street 1:1220 THEIL ST
Practice Address - Street 2:
Practice Address - City:HARTFORD
Practice Address - State:WI
Practice Address - Zip Code:53027-1448
Practice Address - Country:US
Practice Address - Phone:262-670-6595
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-09-22
Last Update Date:2021-09-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI19487-40183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist