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General NPI Number Information
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NPI Number | 1356450126
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Entity Type | Individual
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Provider Name | KRISTEN C MABIE RPH
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Gender | Female
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Dates
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Enumeration Date | 08/29/2006
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 208 LINCOLN AVE
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City | RIO
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State | WI
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Zip | 53960-8015
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Country | US
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Telephone | 920-992-3369
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Fax | 920-992-3371
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Provider Business Mailing Address
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Address Line | 2018 UPHOFF RD
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City | COTTAGE GROVE
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State | WI
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Zip | 53527-9319
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Country | US
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Telephone | 608-839-8381
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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 | 13090
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License Number State | WI
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