Provider Demographics
NPI:1942532270
Name:KRASSELT, JOANNE K (RPH)
Entity Type:Individual
Prefix:MS
First Name:JOANNE
Middle Name:K
Last Name:KRASSELT
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 1:111 DIVISION ST N
Mailing Address - Street 2:
Mailing Address - City:STEVENS POINT
Mailing Address - State:WI
Mailing Address - Zip Code:54481-1150
Mailing Address - Country:US
Mailing Address - Phone:715-341-5613
Mailing Address - Fax:
Practice Address - Street 1:111 DIVISION ST N
Practice Address - Street 2:
Practice Address - City:STEVENS POINT
Practice Address - State:WI
Practice Address - Zip Code:54481-1150
Practice Address - Country:US
Practice Address - Phone:715-341-5613
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-02-11
Last Update Date:2010-02-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI11408183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist