Provider Demographics
NPI:1780860460
Name:KAMINSKY, DENISE MARGARET (RPH)
Entity type:Individual
Prefix:MRS
First Name:DENISE
Middle Name:MARGARET
Last Name:KAMINSKY
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 1:145 N MAIN ST
Mailing Address - Street 2:
Mailing Address - City:FOND DU LAC
Mailing Address - State:WI
Mailing Address - Zip Code:54935-3423
Mailing Address - Country:US
Mailing Address - Phone:920-921-4660
Mailing Address - Fax:920-922-5011
Practice Address - Street 1:145 N MAIN ST
Practice Address - Street 2:
Practice Address - City:FOND DU LAC
Practice Address - State:WI
Practice Address - Zip Code:54935-3423
Practice Address - Country:US
Practice Address - Phone:920-921-4660
Practice Address - Fax:920-922-5011
Is Sole Proprietor?:No
Enumeration Date:2008-01-13
Last Update Date:2008-01-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI13492-040183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist