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General NPI Number Information
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NPI Number | 1134535685
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Entity Type | Individual
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Provider Name | JENA CAPRIOLI
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Gender | Female
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Dates
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Enumeration Date | 07/05/2014
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Last Update Date | 07/05/2014
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Provider Practice Location Address
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Address Line | 12601 W HAMPTON AVE
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City | BUTLER
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State | WI
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Zip | 53007-1730
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Country | US
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Telephone | 262-781-0148
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Fax |
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Provider Business Mailing Address
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Address Line | W290N3920 DRY CREEK CT
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City | PEWAUKEE
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State | WI
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Zip | 53072-3157
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Country | US
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Telephone | 608-215-0328
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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 | 183500000X
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Taxonomy Name | Pharmacist
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License Number | 16293-40
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License Number State | WI
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