Daniel R Knuteson, RPH
Individual provider Active NPI Pharmacist · Deforest, WI
NPI 1780106633 · NPPES record last updated Jul 21, 2022
Key facts
- NPI
- 1780106633
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Pharmacist 183500000X
- License
- 9021 (WI)
- Practice address
- 4502 Oak Springs Cir
Deforest, WI 53532-1712 - Phone
- (608) 846-4899
- NPI assigned
- Jul 12, 2017
- Sex
- Male
- 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
- Registered Pharmacist
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 9021 | WI | MD | Nurse Practitioner |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pharmacist | 183500000X | 9021 | WI | Yes |
Addresses
Primary practice location
4502 Oak Springs Cir
Deforest, WI 53532-1712
Mailing address
4502 Oak Springs Cir
Deforest, WI 53532-1712
Phone (608) 846-4899
Other providers in Deforest, WI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jul 21, 2022. 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.