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NPI Code Detail

MEDICARE: KACIE M BOHLKEN PHARMD.

MEDICARE: KACIE M BOHLKEN PHARMD.
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1183500000XPharmacist21083IA
2183500000XPharmacist13201NE

General Provider Information

NPI Number : 1366728727
Entity Type Code : Individual
Provider Name (Legal Business Name) : KACIE M BOHLKEN PHARMD.
Provider Business Mailing Address
First Line : 320 DAKOTA DUNES BLVD
Second Line : #310
City : DAKOTA DUNES
State : SD
Zip : 57049-5340
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 4650 MORNINGSIDE AVE
Second Line :
City : SIOUX CITY
State : IA
Zip : 51106-2964
Country : US
Telephone Number : 712-276-7744
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 10/31/2011
Last Update Date : 10/31/2011

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Directions to “ KACIE M BOHLKEN PHARMD.” Practice Location

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