Provider Demographics
NPI:1275817157
Name:LINDE, ABBIGAIL (RPH, PHARMD)
Entity Type:Individual
Prefix:
First Name:ABBIGAIL
Middle Name:
Last Name:LINDE
Suffix:
Gender:F
Credentials:RPH, PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:717 8TH AVE
Mailing Address - Street 2:
Mailing Address - City:MONROE
Mailing Address - State:WI
Mailing Address - Zip Code:53566-4000
Mailing Address - Country:US
Mailing Address - Phone:608-325-7020
Mailing Address - Fax:608-325-7026
Practice Address - Street 1:717 8TH AVE
Practice Address - Street 2:
Practice Address - City:MONROE
Practice Address - State:WI
Practice Address - Zip Code:53566-4000
Practice Address - Country:US
Practice Address - Phone:608-325-7020
Practice Address - Fax:608-325-7026
Is Sole Proprietor?:No
Enumeration Date:2011-10-10
Last Update Date:2011-10-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI16396-040183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist