Provider Demographics
NPI:1801145081
Name:MAERTENS, KINSEY OAKLAND (PHARMD)
Entity type:Individual
Prefix:
First Name:KINSEY
Middle Name:OAKLAND
Last Name:MAERTENS
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 1:13725 HWY 5
Mailing Address - Street 2:
Mailing Address - City:CAVALIER
Mailing Address - State:ND
Mailing Address - Zip Code:58220-9506
Mailing Address - Country:US
Mailing Address - Phone:701-370-0650
Mailing Address - Fax:701-265-4948
Practice Address - Street 1:201 E 3RD AVE S STE B
Practice Address - Street 2:
Practice Address - City:CAVALIER
Practice Address - State:ND
Practice Address - Zip Code:58220-4024
Practice Address - Country:US
Practice Address - Phone:701-265-4744
Practice Address - Fax:701-265-4948
Is Sole Proprietor?:No
Enumeration Date:2012-09-05
Last Update Date:2012-09-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ND5414183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist