Healthcare Provider Details

I. General information

NPI: 1396370987
Provider Name (Legal Business Name): BECKY AULT PHARM.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/04/2020
Last Update Date: 06/08/2026
Certification Date: 06/08/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

641 S CENTRAL AVE
MARSHFIELD WI
54449-4104
US

IV. Provider business mailing address

641 S CENTRAL AVE
MARSHFIELD WI
54449-4104
US

V. Phone/Fax

Practice location:
  • Phone: 715-502-3585
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1835P0018X
TaxonomyPharmacist Clinician (PhC)/ Clinical Pharmacy Specialist
License Number17668
License Number StateWI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: