Individual provider Active NPI

Amanda Beth Krznarich, PHARMD

  • Pharmacist
  • Iron Mountain, MI
National Provider Identifier
1972889889
Registry record updated Dec 7, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
15278-040 Issued in WI
Practice address
325 E H St
Iron Mountain, MI 49801
Phone
(906) 774-3300
NPI assigned
Oct 25, 2011
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 7, 2018

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist 183500000X 15278-040 WI Primary

Addresses

Primary practice location

325 E H St
Iron Mountain, MI 49801

Mailing address

325 E H St
Iron Mountain, MI 49801-4760
Phone (906) 774-3300

Other practice location 1

219 W Main St
Little Chute, WI 54140-1751
Phone (920) 687-6193

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

LicenseStateTypeSpecialty
15278-040WIMDPharmacist

Practice roles

OrganizationSpecialtyStatusNew patients
Walgreen Co Past Accepting new patients
Walgreen Co PastSince Feb 27, 2022 Accepting new patients

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1319500800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1544140800000",
    "number": "1972889889",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "325 E H ST",
            "city": "IRON MOUNTAIN",
            "state": "MI",
            "postal_code": "498014760",
            "telephone_number": "906-774-3300"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "325 E H ST",
            "city": "IRON MOUNTAIN",
            "state": "MI",
            "postal_code": "49801",
            "telephone_number": "906-774-3300"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "219 W Main St",
            "address_purpose": "LOCATION",
            "city": "Little Chute",
            "state": "WI",
            "postal_code": "541401751",
            "country_code": "US",
            "telephone_number": "920-687-6193",
            "fax_number": "920-687-6197",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "KRZNARICH",
        "first_name": "AMANDA",
        "middle_name": "BETH",
        "name_prefix": "Mrs.",
        "credential": "PHARMD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-10-25",
        "last_updated": "2018-12-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "WI",
            "license": "15278-040",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Iron Mountain, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 7, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.