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General NPI Number Information
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NPI Number | 1700895992
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Entity Type | Individual
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Provider Name | JAMIE MICHAEL KINJERSKI PHARMD.
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Gender | Male
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Dates
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Enumeration Date | 08/05/2006
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 216 S MILITARY AVE
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City | GREEN BAY
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State | WI
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Zip | 54303-2498
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Country | US
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Telephone | 920-499-0895
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Fax |
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Provider Business Mailing Address
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Address Line | 3570 CROCUS DR
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City | DE PERE
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State | WI
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Zip | 54115
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Country | US
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Telephone | 920-347-4666
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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 | 14710-040
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License Number State | WI
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