Provider Demographics
NPI:1629353842
Name:STUELAND, KEVIN (PHARMD)
Entity Type:Individual
Prefix:
First Name:KEVIN
Middle Name:
Last Name:STUELAND
Suffix:
Gender:M
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1927 N CENTRAL AVE STE B
Mailing Address - Street 2:
Mailing Address - City:MARSHFIELD
Mailing Address - State:WI
Mailing Address - Zip Code:54449-8336
Mailing Address - Country:US
Mailing Address - Phone:715-301-7160
Mailing Address - Fax:715-384-8564
Practice Address - Street 1:1927 N CENTRAL AVE STE B
Practice Address - Street 2:
Practice Address - City:MARSHFIELD
Practice Address - State:WI
Practice Address - Zip Code:54449-8336
Practice Address - Country:US
Practice Address - Phone:715-301-7160
Practice Address - Fax:715-384-8564
Is Sole Proprietor?:No
Enumeration Date:2011-10-19
Last Update Date:2021-02-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WIWI15553040183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist