Makenzie Aesoph
Individual provider Active NPI Pharmacist · Brookings, SD
NPI 1699281154 · NPPES record last updated Dec 20, 2017
Key facts
- NPI
- 1699281154
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Pharmacist 183500000X
- License
- 6323 (SD)
- Practice address
- 2233 6TH St
Brookings, SD 57006-1731 - Phone
- (605) 692-1858
- NPI assigned
- Dec 20, 2017
- 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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 6323 | SD | MD | Pharmacist |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pharmacist | 183500000X | 6323 | SD | Yes |
Addresses
Primary practice location
2233 6TH St
Brookings, SD 57006-1731
Mailing address
2233 6TH St
Brookings, SD 57006-1731
Other providers in Brookings, SD
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Dec 20, 2017. 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.