Active NPI
Heather L Miskulin, PHARMD
- Pharmacist
- Green Bay, WI
National Provider Identifier
1700509973
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- 13929-40
- Practice address
- 635 Main St
Green Bay, WI 54301-4918 - Phone
- (920) 437-0206
- Fax
- (920) 437-0276
- NPI assigned
- Sep 22, 2022
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pharmacist | 183500000X | 13929-40 | WI | Primary |
Addresses
Primary practice location
635 Main St
Green Bay, WI 54301-4918
Mailing address
3546 Brookside Dr
Pulaski, WI 54162-9748
Phone (920) 819-6572
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
- Credentials
- Doctor of Pharmacy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 13929-40 | WI | MD | Pharmacist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1663804800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1663804800000",
"number": "1700509973",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3546 BROOKSIDE DR",
"city": "PULASKI",
"state": "WI",
"postal_code": "541629748",
"telephone_number": "920-819-6572"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "635 MAIN ST",
"city": "GREEN BAY",
"state": "WI",
"postal_code": "543014918",
"telephone_number": "920-437-0206",
"fax_number": "920-437-0276"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MISKULIN",
"first_name": "HEATHER",
"middle_name": "L",
"credential": "PHARMD",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2022-09-22",
"last_updated": "2022-09-22",
"certification_date": "2022-09-22",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "WI",
"license": "13929-40",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Green Bay, WI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 22, 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.