Provider Demographics
NPI:1942564927
Name:HONKE, AMISA M (PHARMD)
Entity Type:Individual
Prefix:MRS
First Name:AMISA
Middle Name:M
Last Name:HONKE
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3700 S GRANGE AVE
Mailing Address - Street 2:
Mailing Address - City:SIOUX FALLS
Mailing Address - State:SD
Mailing Address - Zip Code:57105-6359
Mailing Address - Country:US
Mailing Address - Phone:605-988-9150
Mailing Address - Fax:605-988-9141
Practice Address - Street 1:3700 S GRANGE AVE
Practice Address - Street 2:
Practice Address - City:SIOUX FALLS
Practice Address - State:SD
Practice Address - Zip Code:57105-6359
Practice Address - Country:US
Practice Address - Phone:605-988-9150
Practice Address - Fax:605-988-9141
Is Sole Proprietor?:Yes
Enumeration Date:2012-06-25
Last Update Date:2022-09-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SD5909183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist