Provider Demographics
NPI:1053957217
Name:KIRMSE, KATHRYN (PHARMD)
Entity type:Individual
Prefix:
First Name:KATHRYN
Middle Name:
Last Name:KIRMSE
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:
Other - First Name:KATHRYN
Other - Middle Name:
Other - Last Name:CERNEY
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PHARMD
Mailing Address - Street 1:7133 FIELD FLOWER WAY
Mailing Address - Street 2:
Mailing Address - City:MADISON
Mailing Address - State:WI
Mailing Address - Zip Code:53718-3431
Mailing Address - Country:US
Mailing Address - Phone:715-641-0744
Mailing Address - Fax:
Practice Address - Street 1:1008 17TH AVE
Practice Address - Street 2:
Practice Address - City:MONROE
Practice Address - State:WI
Practice Address - Zip Code:53566-2005
Practice Address - Country:US
Practice Address - Phone:608-325-2151
Practice Address - Fax:608-325-2153
Is Sole Proprietor?:Yes
Enumeration Date:2019-11-22
Last Update Date:2019-11-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI17877-40183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist