Emma Marie Iselin Paulson

Primary specialty

PharmacistTaxonomy code 183500000X

License

20405-40 Issued in WI

Practice address

W7810 State Road 21 Ste B
Wautoma, WI 54982-7702

Phone

(920) 787-9561

NPI assigned

Jun 3, 2022

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

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Wautoma Hometown Pharmacy LLC

  • Community/Retail Pharmacy
  • Wautoma, WI
  • NPI 1174187827
  NPD (past)

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

{
    "created_epoch": "1654214400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1654214400000",
    "number": "1306585559",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "W7810 STATE ROAD 21 STE B",
            "city": "WAUTOMA",
            "state": "WI",
            "postal_code": "549827702",
            "telephone_number": "920-787-9561"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "W7810 STATE ROAD 21 STE B",
            "city": "WAUTOMA",
            "state": "WI",
            "postal_code": "549827702",
            "telephone_number": "920-787-9561"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PAULSON",
        "first_name": "EMMA MARIE",
        "middle_name": "ISELIN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-06-03",
        "last_updated": "2022-06-03",
        "certification_date": "2022-06-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "WI",
            "license": "20405-40",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Christiana Nichols, RDH
• Erika Niznik, PHARMD
• Jane Oligney, SAC-IT
• Kate Elizabeth Onsgard, MS, LPC, CSAC-IT
• Tiffany Otto, DDS
• Baron Perlman, PH D
• Michael Peterson, PHARMR
• Keela Marie Phillips, APSW
• Tanya L Pierce, RDH
• William Russell Pinkonsly, M.D.

• Pharmacist in Wautoma, WI
• Providers in Wautoma, WI by specialty
• Pharmacist in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 3, 2022; 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.