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General NPI Number Information
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NPI Number | 1083330716
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Entity Type | Individual
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Provider Name | SHAWNEE KLATT PHARMD
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Gender | Female
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Dates
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Enumeration Date | 10/14/2022
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Last Update Date | 10/14/2022
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Provider Practice Location Address
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Address Line | 201 N MAYFAIR RD
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City | WAUWATOSA
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State | WI
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Zip | 53226-4216
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Country | US
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Telephone | 414-259-7424
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Fax | 414-409-7748
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Provider Business Mailing Address
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Address Line | 6376 S 35TH ST APT 2
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City | FRANKLIN
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State | WI
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Zip | 53132-8706
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Country | US
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Telephone | 815-871-4232
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1835P2201X
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Taxonomy Name | Ambulatory Care Pharmacist
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License Number | 20301-40
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License Number State | WI
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