Healthcare Provider Details

I. General information

NPI: 1457260739
Provider Name (Legal Business Name): AMY POPPY PHARMD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/03/2026
Last Update Date: 09/03/2026
Certification Date: 09/03/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1818 N MEADE ST
APPLETON WI
54911-3454
US

IV. Provider business mailing address

W4945 HICKORY HILLS RD
CHILTON WI
53014-9724
US

V. Phone/Fax

Practice location:
  • Phone: 920-454-3200
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1835P2201X
TaxonomyAmbulatory Care Pharmacist
License Number23313-40
License Number StateWI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: