Healthcare Provider Details

I. General information

NPI: 1487999629
Provider Name (Legal Business Name): KAREN BORSHEIM RPHH
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 11/28/2012
Last Update Date: 11/28/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1000 W NORTHLAND AVE
APPLETON WI
54914-1419
US

IV. Provider business mailing address

2405 W TWIN WILLOWS DR
APPLETON WI
54914-6872
US

V. Phone/Fax

Practice location:
  • Phone: 920-739-0934
  • Fax:
Mailing address:
  • Phone: 920-731-0871
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License Number9715-40
License Number StateWI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: