Kelly Bakic
Individual provider Active NPI Pharmacist · Menomonee Falls, WI
NPI 1003449646 · NPPES record last updated Feb 21, 2020
Key facts
- NPI
- 1003449646
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Pharmacist 183500000X
- License
- 18799-40 (WI)
- Practice address
- N56W15501 Silver Spring Dr
Menomonee Falls, WI 53051-5971 - Phone
- (262) 703-9781
- NPI assigned
- Feb 21, 2020
- Sex
- Female
- Sole proprietor
- Yes
Organizations & group practices 2
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 18799-40 | WI | MD | Pharmacist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Walgreen Co | Past |
Accepting new patients | |
| Walgreen Co | Past |
Accepting new patients |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pharmacist | 183500000X | 18799-40 | WI | Yes |
Addresses
Primary practice location
N56W15501 Silver Spring Dr
Menomonee Falls, WI 53051-5971
Mailing address
N56W15501 Silver Spring Dr
Menomonee Falls, WI 53051-5971
Other providers in Menomonee Falls, WI
- Ann M Bachar
- Eric J Bachar
- Badger Dental Wi LLC
- Lina M. Badwan
- Kim M Baker
- Balaji Group, Inc
- Denise H. Balistrieri
- Betsy J. Baranek
- Gregory Barczak
- Brett A Barkimer
All providers in Menomonee Falls, WI · Pharmacist in Wisconsin
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Feb 21, 2020. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.