Individual
KIMBERLY ERICKSON HOLDENER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
600 HIGHLAND AVE, PHARMACY DEPT. MAILCODE 1530, MADISON, WI 53792-0001
(608) 263-1290
Mailing address
5240 SNAPDRAGON TRL, FITCHBURG, WI 53711-7642
(608) 263-1290
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
117641-2
MN
183500000X
Pharmacist
Primary
14008-040
WI
183500000X
Pharmacist
26020453A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
117641-2
PHARMACIST
MN
01
—
14008-040
PHARMACIST
WI
01
—
26020453A
PHARMACIST
IN
Enumeration date
11/09/2006
Last updated
07/08/2007
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