Healthcare Provider Details

I. General information

NPI: 1598680472
Provider Name (Legal Business Name): NOURINE KHALED MOHAMED ABDEL QASSEM PHARMACIST
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/11/2026
Last Update Date: 08/11/2026
Certification Date: 08/11/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

N58W17708 TIMMS PRAIRIE WALK
MENOMONEE FALLS WI
53051-5572
US

IV. Provider business mailing address

N58W17708 TIMMS PRAIRIE WALK
MENOMONEE FALLS WI
53051-5572
US

V. Phone/Fax

Practice location:
  • Phone: 608-289-5908
  • Fax:
Mailing address:
  • Phone: 608-289-5908
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License Number2358540
License Number StateWI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: