Provider Demographics
NPI:1649883299
Name:KRINGEN, DAVID JOHN (RPH)
Entity type:Individual
Prefix:
First Name:DAVID
Middle Name:JOHN
Last Name:KRINGEN
Suffix:
Gender:M
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:340 W WASHINGTON ST
Mailing Address - Street 2:
Mailing Address - City:BRAINERD
Mailing Address - State:MN
Mailing Address - Zip Code:56401-2924
Mailing Address - Country:US
Mailing Address - Phone:218-825-0027
Mailing Address - Fax:
Practice Address - Street 1:122 W MADISON AVE
Practice Address - Street 2:
Practice Address - City:GRANTSBURG
Practice Address - State:WI
Practice Address - Zip Code:54840-7022
Practice Address - Country:US
Practice Address - Phone:715-463-2525
Practice Address - Fax:715-463-5343
Is Sole Proprietor?:No
Enumeration Date:2020-08-24
Last Update Date:2025-01-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN123784183500000X
WI20946-40183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist