Provider Demographics
NPI:1407292634
Name:BERGMANN, KAREN ANN (PHARMD, MBA, RPH)
Entity Type:Individual
Prefix:DR
First Name:KAREN
Middle Name:ANN
Last Name:BERGMANN
Suffix:
Gender:F
Credentials:PHARMD, MBA, RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1400 E BRADY ST
Mailing Address - Street 2:
Mailing Address - City:MILWAUKEE
Mailing Address - State:WI
Mailing Address - Zip Code:53202-1615
Mailing Address - Country:US
Mailing Address - Phone:414-272-2171
Mailing Address - Fax:
Practice Address - Street 1:1400 E BRADY ST
Practice Address - Street 2:
Practice Address - City:MILWAUKEE
Practice Address - State:WI
Practice Address - Zip Code:53202-1615
Practice Address - Country:US
Practice Address - Phone:414-272-2171
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-05-14
Last Update Date:2013-05-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI1044540183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist