Provider Demographics
NPI:1558421032
Name:KAWULIA, LINDA (RPH)
Entity Type:Individual
Prefix:MRS
First Name:LINDA
Middle Name:
Last Name:KAWULIA
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 1:1606 HIGHWAY 71
Mailing Address - Street 2:
Mailing Address - City:INTERNATIONAL FALLS
Mailing Address - State:MN
Mailing Address - Zip Code:56649-2161
Mailing Address - Country:US
Mailing Address - Phone:218-283-3246
Mailing Address - Fax:
Practice Address - Street 1:1606 HIGHWAY 71
Practice Address - Street 2:
Practice Address - City:INTERNATIONAL FALLS
Practice Address - State:MN
Practice Address - Zip Code:56649-2161
Practice Address - Country:US
Practice Address - Phone:218-283-3246
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-12-12
Last Update Date:2008-08-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN116322-1183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist
Provider Identifiers
StateIdentifier IDID TypeIssuer
MN116322-1OtherPHARMACIST LICENSE