Jill Wettstein, PHARMD
Individual provider Active NPI Pharmacist · Kenmare, ND
NPI 1275905200 · NPPES record last updated Oct 29, 2015
Key facts
- NPI
- 1275905200
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Pharmacist 183500000X
- License
- RPH5176 (ND)
- Practice address
- 109 1St Ave NW
Kenmare, ND 58746-7165 - Phone
- (701) 385-4257
- NPI assigned
- Oct 29, 2015
- Sex
- Female
- Sole proprietor
- No
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
- Credentials
- Doctor of Pharmacy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 119394 | MN | MD | Pharmacist |
| RPH5176 | ND | MD | Pharmacist |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pharmacist | 183500000X | 119394 | MN | |
| Pharmacist | 183500000X | RPH5176 | ND | Yes |
Addresses
Primary practice location
109 1St Ave NW
Kenmare, ND 58746-7165
Mailing address
109 1St Ave NW
PO Box 895
Kenmare, ND 58746-7165
Phone (701) 385-4257
Other providers in Kenmare, ND
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Oct 29, 2015. 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.