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General NPI Number Information
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NPI Number | 1164031134
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Entity Type | Individual
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Provider Name | HANNA KLEIBOEKER PHARMD
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Gender | Female
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Dates
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Enumeration Date | 07/27/2020
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Last Update Date | 07/27/2020
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Provider Practice Location Address
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Address Line | 600 HIGHLAND AVE
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City | MADISON
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State | WI
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Zip | 53792-0001
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Country | US
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Telephone | 608-890-8114
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Fax |
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Provider Business Mailing Address
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Address Line | 1632 NE WOODLAND SHORES DR
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City | LEES SUMMIT
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State | MO
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Zip | 64086-7010
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Country | US
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Telephone | 816-210-8395
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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 | 20384-40
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License Number State | WI
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