KIMBERLEY BEVAN (NPI# 1518384643) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1518384643 |
| Entity Type | Individual |
| Full Name | KIMBERLEY BEVAN |
| Practice Address |
1284 East Summit Avenue Suite 100 Oconomowoc WI 53066 |
| Practice Telephone | 2625698204 |
| Mailing Telephone | 2625698204 |
| Enumeration Date | 2014-03-26 |
| Last Update Date | 2014-03-26 |
| Gender Code | F |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 183500000X | Pharmacist | 03-2-14081 | OH | Pharmacy Service Providers |
| Y | 183500000X | Pharmacist | 10040-40 | WI | Pharmacy Service Providers |
| Street Address |
1284 EAST SUMMIT AVENUE SUITE 100 |
| City | OCONOMOWOC |
| State | WI |
| Zip Code | 53066 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1376109082 | Sharon Legwinski | Occupational Therapist | 2195 N. Summit Way, Oconomowoc, WI 53066 | 2019-05-17 |
| 1033676390 | Paladina Health, LLC | Family Medicine | Paladina Health Oconomowoc Sentry Equipment Circle, 966 Blue Ribbon Circle N, Oconomowoc, WI 53066 | 2019-02-22 |
| 1689145500 | Oconomowoc Developmental Training Center of Wisconsin LLC | Residential Treatment Facility, Emotionally Disturbed Children | 36100 Genesee Lake School, Oconomowoc, WI 53066 | 2018-12-17 |
| 1649748203 | Ginny Dacquisto | Dietitian, Registered | 1134 Lily Rd, Oconomowoc, WI 53066 | 2018-11-12 |
| 1174000764 | Aimee M Metzger | Social Worker | 405 E Forest St Ste 113, Oconomowoc, WI 53066 | 2018-07-26 |
| 1023482569 | Forefront Dermatology, S.c. | Dermatology | 1320 Pabst Farms Cir, Suite 180, Oconomowoc, WI 53066 | 2015-11-20 |
| 1962890475 | Monica Rodriguez | Counselor | 405 East Forest Street, Suite 119, Oconomowoc, WI 53066 | 2015-01-06 |
| 1699098905 | Heidi Eckroth Nunnemacher | Counselor | 35315 Genesee Lake Road, Oconomowoc, WI 53066 | 2010-03-02 |
| 1669705240 | Oconomowoc Development Training Center Ll | Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities | 3222 N. Silver Cedar Rd., Oconomowoc, WI 53066 | 2009-09-14 |
| 1538306378 | Avolen, LLC | Massage Therapist | 206 S. Silver Lake St., Oconomowoc, WI 53066 | 2009-01-15 |
| Find all providers in zip 53066 | ||||
| Taxonomy Code | 183500000X |
| Grouping | Pharmacy Service Providers |
| Classification | Pharmacist |
| An individual licensed by the appropriate state regulatory agency to engage in the practice of pharmacy. The practice of pharmacy includes, but is not limited to, assessment, interpretation, evaluation, and implementation, initiation, monitoring or modification of medication and or medical orders; the compounding or dispensing of medication and or medical orders; participation in drug and device procurement, storage, and selection; drug administration; drug regimen reviews; drug or drug-related research; provision of patient education and the provision of those acts or services necessary to provide medication therapy management services in all areas of patient care. |
| Notes: Source: Adapted from National Association of Boards of Pharmacy Model State Pharmacy Act, Article 1, Section 104. [1/1/2006: definition modified, source modified] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1083244032 | Kyle Mcgovern | Pharmacist | 1284 N Summit Ave Ste 100, Oconomowoc, WI 53066-4459 | 2020-01-17 |
| 1306268222 | Carey Ann Zigler | Pharmacist | 1260 Brown St Ste A, Oconomowoc, WI 53066-2491 | 2014-01-11 |
| 1477990323 | Stephen Ernest Paquin | Pharmacist | 36596 Upper Cape Ct, Oconomowoc, WI 53066-9478 | 2013-06-02 |
| 1538413927 | Colleen Englebert | Pharmacist | 1260 Brown St, Suite A, Oconomowoc, WI 53066-2491 | 2012-11-06 |
| 1861778821 | Louis John Soefker Jr. | Pharmacist | 1300 Redwing Dr, Oconomowoc, WI 53066-2379 | 2011-10-21 |
| 1285949214 | Brian T Wojczak | Pharmacist | 1450 Summit Ave, Oconomowoc, WI 53066-4618 | 2010-08-14 |
| 1366433963 | Margaret Anne Dare | Pharmacist | 1040 S Opengate Ct, Oconomowoc, WI 53066-8770 | 2005-11-02 |
| 1760099618 | Mary Jo Houston | Pharmacist | 1021 Summit Ave, Oconomowoc, WI 53066-4499 | 2020-09-24 |
| 1124652789 | Sunny Dineshkumar Patel | Pharmacist | 1021 Summit Ave, Oconomowoc, WI 53066-4457 | 2020-02-23 |
| 1134752793 | Skyler Stubblefield | Pharmacist | 1021 Summit Ave, Oconomowoc, WI 53066-4499 | 2020-02-21 |
| Find all providers in OCONOMOWOC | ||||
| City | OCONOMOWOC |
| Zip Code | 53066 |
Please comment or provide details below to improve the information on KIMBERLEY BEVAN.
| 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.