Healthcare Provider Details

I. General information

NPI: 1780596569
Provider Name (Legal Business Name): ALEXA KAY BRESKE
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/17/2026
Last Update Date: 09/17/2026
Certification Date: 09/17/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4415 STATE ROAD 16
LA CROSSE WI
54601-1815
US

IV. Provider business mailing address

4415 STATE ROAD 16
LA CROSSE WI
54601-1815
US

V. Phone/Fax

Practice location:
  • Phone: 608-779-0939
  • Fax:
Mailing address:
  • Phone: 608-779-0939
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License Number23664-40
License Number StateWI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: