Ryan Vanevenhoven
Individual provider Active NPI Pharmacist · Appleton, WI
NPI 1487288403 · NPPES record last updated Feb 28, 2020
Key facts
- NPI
- 1487288403
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Pharmacist 183500000X
- License
- 18038 (WI)
- Practice address
- 729 W Northland Ave
Appleton, WI 54914-1426 - Phone
- (920) 954-8100
- NPI assigned
- Feb 28, 2020
- Sex
- Male
- Sole proprietor
- No
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 |
|---|---|---|---|
| 18038 | WI | MD | Pharmacist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Walgreen Co | Current |
Accepting new patients | |
| Walgreen Co | Past |
Accepting new patients |
Locations
729 W Northland Ave
Appleton, WI 54914
Phone (920) 954-8100
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pharmacist | 183500000X | 18038 | WI | Yes |
Addresses
Primary practice location
729 W Northland Ave
Appleton, WI 54914-1426
Mailing address
729 W Northland Ave
Appleton, WI 54914-1426
Phone (920) 954-8100
Other providers in Appleton, WI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Feb 28, 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.