Provider Demographics
NPI:1821325192
Name:KUIVINEN, JENNIFER ANN (RPH, CIP)
Entity Type:Individual
Prefix:MS
First Name:JENNIFER
Middle Name:ANN
Last Name:KUIVINEN
Suffix:
Gender:F
Credentials:RPH, CIP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11130 HASSLER WOODS TRL
Mailing Address - Street 2:
Mailing Address - City:ALANSON
Mailing Address - State:MI
Mailing Address - Zip Code:49706-8606
Mailing Address - Country:US
Mailing Address - Phone:906-231-0172
Mailing Address - Fax:
Practice Address - Street 1:250 MEIJER DR
Practice Address - Street 2:
Practice Address - City:GAYLORD
Practice Address - State:MI
Practice Address - Zip Code:49735-7241
Practice Address - Country:US
Practice Address - Phone:906-231-0172
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-11-07
Last Update Date:2014-10-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI5302031560183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist