Healthcare Provider Details

I. General information

NPI: 1215854062
Provider Name (Legal Business Name): RYAN MICHAEL JERKINS PHARMD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/02/2026
Last Update Date: 07/02/2026
Certification Date: 07/02/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6701 MINERAL POINT RD
MADISON WI
53705-4241
US

IV. Provider business mailing address

625 N PLEASANT VIEW RD UNIT 110
MIDDLETON WI
53562-5153
US

V. Phone/Fax

Practice location:
  • Phone: 608-833-4588
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License Number23468-40
License Number StateWI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: