Healthcare Provider Details

I. General information

NPI: 1366367138
Provider Name (Legal Business Name): KOR NOU XIONG PHARMD
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

8901 W LINCOLN AVE
WEST ALLIS WI
53227-2409
US

IV. Provider business mailing address

6911 W CLOVERNOOK ST
MILWAUKEE WI
53223-5757
US

V. Phone/Fax

Practice location:
  • Phone: 414-328-6000
  • Fax:
Mailing address:
  • Phone: 608-877-6600
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License Number23598-40
License Number StateWI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: