Jessica Kienast, PHARMD

Primary specialty

PharmacistTaxonomy code 183500000X

License

15906-40 Issued in WI

Practice address

377 N Rolling Meadows Dr
Fond Du Lac, WI 54937-9726

Phone

(920) 921-9591

NPI assigned

Oct 17, 2020

Last updated

Oct 17, 2020By the provider in NPPES

Sex

Female

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Electronic endpoints 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Doctor of Pharmacy

State licenses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1602892800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1602892800000",
    "number": "1215536669",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "377 N ROLLING MEADOWS DR",
            "city": "FOND DU LAC",
            "state": "WI",
            "postal_code": "549379726",
            "telephone_number": "920-921-9591"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "377 N ROLLING MEADOWS DR",
            "city": "FOND DU LAC",
            "state": "WI",
            "postal_code": "549379726",
            "telephone_number": "920-921-9591"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KIENAST",
        "first_name": "JESSICA",
        "credential": "PHARMD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-10-17",
        "last_updated": "2020-10-17",
        "certification_date": "2020-10-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "WI",
            "license": "15906-40",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "jakiena.s01643.us@wal-mart.com",
            "affiliation": "N",
            "endpointDescription": "email",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "email",
            "address_1": "377 N Rolling Meadows Dr",
            "city": "Fond Du Lac",
            "state": "WI",
            "country_code": "US",
            "postal_code": "549379726",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Kevin L Ketchum, M.D.
• Kimberly Ketter, R.N.
• Michael J Keyes, MD
• Ilya A Khotimsky, M.D.
• Randall K Kielbasa
• Daniel James Kierstead, OD
• Stephanie Kikkert, CSAC
• Dawn Kimpel
• Lisa King
• Wyatt Kinner

• Pharmacist in Fond Du Lac, WI
• Providers in Fond Du Lac, WI by specialty
• Pharmacist in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 17, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.