Healthcare Provider Details

I. General information

NPI: 1134173362
Provider Name (Legal Business Name): ERIN NICOLE NEWKIRK PHARMD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/20/2006
Last Update Date: 07/21/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9200 W WISCONSIN AVE
MILWAUKEE WI
53226-3522
US

IV. Provider business mailing address

N99W14514 TWIN MEADOWS DR
GERMANTOWN WI
53022-6612
US

V. Phone/Fax

Practice location:
  • Phone: 262-805-6577
  • Fax:
Mailing address:
  • Phone: 262-293-3757
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code1835P1200X
TaxonomyPharmacotherapy Pharmacist
License Number19737
License Number StateIA
# 2
Primary TaxonomyY
Taxonomy Code1835P0018X
TaxonomyPharmacist Clinician (PhC)/ Clinical Pharmacy Specialist
License Number13420-040
License Number StateWI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: