Provider Demographics
NPI:1760973606
Name:WNUK, KATHLEEN KRISTEN (RPH)
Entity Type:Individual
Prefix:MRS
First Name:KATHLEEN
Middle Name:KRISTEN
Last Name:WNUK
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 1:1039 SQUARE DR
Mailing Address - Street 2:
Mailing Address - City:PHOENIXVILLE
Mailing Address - State:PA
Mailing Address - Zip Code:19460-3599
Mailing Address - Country:US
Mailing Address - Phone:703-623-1161
Mailing Address - Fax:
Practice Address - Street 1:1039 SQUARE DR
Practice Address - Street 2:
Practice Address - City:PHOENIXVILLE
Practice Address - State:PA
Practice Address - Zip Code:19460-3599
Practice Address - Country:US
Practice Address - Phone:700-362-3116
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-05-26
Last Update Date:2018-05-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PARP4485181835P2201X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1835P2201XPharmacy Service ProvidersPharmacistAmbulatory Care