MS. LISA MARIE MLODZIK (NPI# 1417225731) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1417225731 |
| Entity Type | Individual |
| Full Name | MS. LISA MARIE MLODZIK |
| Credential | PHARM D, CGP, FASCP |
| Practice Address |
1316 30th Ct Kenosha WI 53144-3064 |
| Practice Telephone | 2625532145 |
| Practice Fax Number | 2625532145 |
| Mailing Telephone | 2625532145 |
| Mailing Fax Number | 2625532145 |
| Enumeration Date | 2011-12-01 |
| Last Update Date | 2011-12-01 |
| Gender Code | F |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 1835P1200X |
Pharmacist Specialization: Pharmacotherapy |
114364-9 | MN | Pharmacy Service Providers |
| Y | 1835P0018X |
Pharmacist Specialization: Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist |
12249 | WI | Pharmacy Service Providers |
| Street Address |
1316 30TH CT |
| City | KENOSHA |
| State | WI |
| Zip Code | 53144-3064 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1902410202 | Dpt Holdings LLC | Occupational Therapist | 3825 39th Ave #110, Kenosha, WI 53144 | 2020-09-03 |
| 1225641392 | Eunice Boatin | Social Worker | Kenosha Human Development Services, 3536 52nd Street, Kenosha, WI 53144 | 2020-08-28 |
| 1881250256 | Shoptikal LLC | Eyewear Supplier (Equipment, not the service) | 3621 Market Lane, Kenosha, WI 53144 | 2019-05-11 |
| 1124540067 | Kaitlyn King | Speech-Language Pathologist | 5219 88th Ave., Kenosha, WI 53144 | 2017-07-12 |
| 1174992721 | Claire Ann Adams | Acupuncturist | 5416 52nd Street, Kenosha, WI 53144 | 2015-09-24 |
| 1285017087 | Jessica Lynn Gillengerten | Acupuncturist | 4235 Green Bay Rd., Suite #10, Kenosha, WI 53144 | 2015-06-30 |
| 1750704656 | Amanda Kay Kreuzer | Occupational Therapy Assistant | 3109 30th Ave, Kenosha, WI 53144 | 2014-01-28 |
| 1841626785 | B7 Pharmacy Inc | Pharmacy | 3825 39th Ave Ste 100, Kenosha, WI 53144 | 2013-09-24 |
| 1124326764 | Wisconsin Cvs Pharmacy LLC | Durable Medical Equipment & Medical Supplies | 3710 57th Ave, Kenosha, WI 53144 | 2011-03-07 |
| 1982931291 | Roman Bilak | General Practice | 4126 - 7th Street, Kemosha, WI 53144 | 2009-11-06 |
| Find all providers in zip 53144 | ||||
| Taxonomy Code | 1835P0018X |
| Grouping | Pharmacy Service Providers |
| Classification | Pharmacist |
| Specialization | Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist |
| Pharmacist Clinician/Clinical Pharmacy Specialist is a pharmacist with additional training and an expanded scope of practice that may include prescriptive authority, therapeutic management, and disease management. |
| Notes: Source: National Uniform Claim Committee, 2007 [1/1/2008: new] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1770194995 | Jill Rae Dworschack | Pharmacist | 2811 18th St, Kenosha, WI 53140-4665 | 2020-08-11 |
| 1366063133 | Lisa Neyens | Pharmacist | 6308 8th Ave, Kenosha, WI 53143-5031 | 2020-05-02 |
| 1518364397 | Ranjitha Inguva | Pharmacist | 5710 75th St, Kenosha, WI 53142-3635 | 2014-11-22 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1316560311 | Sarah Seward | Pharmacist | 6737 W Washington St Ste 4300, West Allis, WI 53214-5651 | 2020-05-26 |
| 1861025371 | Addie Marie Littrell | Pharmacist | 624 S Church Street, Pharmacy Department, Watertown, WI 53094 | 2020-02-13 |
| 1528544798 | Sarah A Abraham | Pharmacist | 3801 N Richmond St, Appleton, WI 54913-9631 | 2018-07-11 |
| 1497280218 | Dennis Alfred Malone Jr. | Pharmacist | 211 Ramsland St, Westby, WI 54667-1031 | 2017-04-30 |
| 1871980193 | Alan R Rosenthal | Pharmacist | 6930 N Beech Tree Dr, Milwaukee, WI 53209 | 2015-04-24 |
| 1831586700 | Erika Aldag | Pharmacist | 235 E Pittsburgh Ave Apt 310, Milwaukee, WI 53204-4335 | 2015-04-18 |
| 1245629716 | Donald Lee Michalski | Pharmacist | 1 Classic Cir, Madison, WI 53719-4437 | 2015-01-21 |
| 1467840801 | Pooja Arora | Pharmacist | 7545 Tree Ln Apt 102g, Madison, WI 53717-2185 | 2015-01-08 |
| 1750650453 | Patricia Fowler | Pharmacist | 5054 Valley Heights Rd, Oshkosh, WI 54904-9354 | 2011-12-26 |
| 1740565217 | Tracy Ann Junker | Pharmacist | 2717 E Denton Ave, Saint Francis, WI 53235-5447 | 2011-10-17 |
| Find all providers with the same taxonomy | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.