Provider Demographics
NPI:1508023102
Name:HARTKOPF, KATHERINE JO (PHARMD)
Entity Type:Individual
Prefix:
First Name:KATHERINE
Middle Name:JO
Last Name:HARTKOPF
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:
Other - First Name:KATHERINE
Other - Middle Name:
Other - Last Name:HOLMES
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PHARMD
Mailing Address - Street 1:8501 EXCELSIOR DRIVE
Mailing Address - Street 2:RM. 337
Mailing Address - City:MADISON
Mailing Address - State:WI
Mailing Address - Zip Code:53717
Mailing Address - Country:US
Mailing Address - Phone:608-263-6900
Mailing Address - Fax:
Practice Address - Street 1:8501 EXCELSIOR DRIVE
Practice Address - Street 2:RM. 337
Practice Address - City:MADISON
Practice Address - State:WI
Practice Address - Zip Code:53717
Practice Address - Country:US
Practice Address - Phone:608-263-6900
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-05-21
Last Update Date:2012-11-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI390200000X
WI15186-40183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program
Provider Identifiers
StateIdentifier IDID TypeIssuer
WI15186-40OtherPHARMACIST