Provider Demographics
NPI:1588054027
Name:ROMANSKI, KEVIN
Entity type:Individual
Prefix:
First Name:KEVIN
Middle Name:
Last Name:ROMANSKI
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5800 S 108TH ST
Mailing Address - Street 2:
Mailing Address - City:HALES CORNERS
Mailing Address - State:WI
Mailing Address - Zip Code:53130-1912
Mailing Address - Country:US
Mailing Address - Phone:414-525-0763
Mailing Address - Fax:855-773-9178
Practice Address - Street 1:5800 S 108TH ST
Practice Address - Street 2:
Practice Address - City:HALES CORNERS
Practice Address - State:WI
Practice Address - Zip Code:53130-1912
Practice Address - Country:US
Practice Address - Phone:414-525-0763
Practice Address - Fax:855-773-9178
Is Sole Proprietor?:No
Enumeration Date:2015-02-04
Last Update Date:2020-10-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI14629-40183500000X
WI14629-0401835P0018X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1835P0018XPharmacy Service ProvidersPharmacistPharmacist Clinician (PhC)/ Clinical Pharmacy Specialist
No183500000XPharmacy Service ProvidersPharmacist