Healthcare Provider Details

I. General information

NPI: 1205761467
Provider Name (Legal Business Name): KIMBERLY L BURKHALTER PHARMD, RPH, MBA
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/17/2026
Last Update Date: 06/17/2026
Certification Date: 06/17/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

700 WEST AVE S
LA CROSSE WI
54601-4783
US

IV. Provider business mailing address

700 WEST AVE S
LA CROSSE WI
54601-4783
US

V. Phone/Fax

Practice location:
  • Phone: 608-392-9290
  • Fax:
Mailing address:
  • Phone: 608-392-9290
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1835C0205X
TaxonomyCritical Care Pharmacist
License Number13058-40
License Number StateWI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: