Beth Marie Bennin, PHARMD
Individual provider Active NPI Pharmacist · Kimberly, WI
NPI 1598103756 · NPPES record last updated Jun 10, 2013
Key facts
- NPI
- 1598103756
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Pharmacist 183500000X
- License
- 15054-040 (WI)
- Practice address
- 800 E Maes Ave
Kimberly, WI 54136-1527 - Phone
- (920) 788-9154
- NPI assigned
- Jun 10, 2013
- 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 |
|---|---|---|---|
| 15054-040 | WI | MD | Pharmacist |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pharmacist | 183500000X | 15054-040 | WI | Yes |
Addresses
Primary practice location
800 E Maes Ave
Kimberly, WI 54136-1527
Mailing address
800 E Maes Ave
Kimberly, WI 54136-1527
Phone (920) 788-9154
Other providers in Kimberly, WI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jun 10, 2013. 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.