Provider Demographics
NPI:1437041613
Name:KRASKA-ANDERSON, ANDREW (RPH)
Entity type:Individual
Prefix:
First Name:ANDREW
Middle Name:
Last Name:KRASKA-ANDERSON
Suffix:
Gender:M
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7111 104TH AVE UNIT J
Mailing Address - Street 2:
Mailing Address - City:KENOSHA
Mailing Address - State:WI
Mailing Address - Zip Code:53142-8302
Mailing Address - Country:US
Mailing Address - Phone:847-505-8747
Mailing Address - Fax:
Practice Address - Street 1:7111 104TH AVE UNIT J
Practice Address - Street 2:
Practice Address - City:KENOSHA
Practice Address - State:WI
Practice Address - Zip Code:53142-8302
Practice Address - Country:US
Practice Address - Phone:847-505-8747
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-07-21
Last Update Date:2025-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI22459-40183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist