Provider Demographics
NPI:1326329244
Name:SCHAEFER, KATHRYN (RPH)
Entity Type:Individual
Prefix:
First Name:KATHRYN
Middle Name:
Last Name:SCHAEFER
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 1:9729 W HUNT CLUB DR
Mailing Address - Street 2:
Mailing Address - City:MEQUON
Mailing Address - State:WI
Mailing Address - Zip Code:53097-3628
Mailing Address - Country:US
Mailing Address - Phone:414-732-3324
Mailing Address - Fax:
Practice Address - Street 1:1915 WISCONSIN AVE
Practice Address - Street 2:
Practice Address - City:GRAFTON
Practice Address - State:WI
Practice Address - Zip Code:53024-2605
Practice Address - Country:US
Practice Address - Phone:262-377-0352
Practice Address - Fax:262-377-0454
Is Sole Proprietor?:No
Enumeration Date:2011-09-06
Last Update Date:2011-09-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI11163183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist