Healthcare Provider Details

I. General information

NPI: 1528052941
Provider Name (Legal Business Name): KATHRYN NEUMANN SPINNIKEN RPH, CGP, MBA
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/31/2005
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

550 MUNSON AVE
TRAVERSE CITY MI
49686-3580
US

IV. Provider business mailing address

6730 E ALPERS RD
LAKE LEELANAU MI
49653-9634
US

V. Phone/Fax

Practice location:
  • Phone: 231-935-8734
  • Fax:
Mailing address:
  • Phone: 231-271-6696
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1835G0303X
TaxonomyGeriatric Pharmacist
License Number5302029519
License Number StateMI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: