Healthcare Provider Details

I. General information

NPI: 1417779638
Provider Name (Legal Business Name): CHRISTINA CASH PHARMD, CAA
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/29/2024
Last Update Date: 01/13/2025
Certification Date: 01/13/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3200 PLEASANT VALLEY RD
WEST BEND WI
53095-9274
US

IV. Provider business mailing address

3200 PLEASANT VALLEY RD
WEST BEND WI
53095-9274
US

V. Phone/Fax

Practice location:
  • Phone: 262-836-5533
  • Fax:
Mailing address:
  • Phone: 262-836-7300
  • Fax: 262-836-7301

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code367H00000X
TaxonomyAnesthesiologist Assistant
License Number574-17
License Number StateWI
# 2
Primary TaxonomyN
Taxonomy Code183500000X
TaxonomyPharmacist
License Number19041-40
License Number StateWI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: