Provider Demographics
NPI:1437757069
Name:GARANT, KERRI LYNN (RPH)
Entity type:Individual
Prefix:MS
First Name:KERRI
Middle Name:LYNN
Last Name:GARANT
Suffix:
Gender:F
Credentials:RPH
Other - Prefix:
Other - First Name:
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Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:WALMART PHARMACY 10-1650
Mailing Address - Street 2:825 E. GREEN BAY AVENUE
Mailing Address - City:SAUKVILLE
Mailing Address - State:WI
Mailing Address - Zip Code:53080
Mailing Address - Country:US
Mailing Address - Phone:262-284-9881
Mailing Address - Fax:262-284-1174
Practice Address - Street 1:WALMART PHARMACY 10-1650
Practice Address - Street 2:825 E. GREEN BAY AVENUE
Practice Address - City:SAUKVILLE
Practice Address - State:WI
Practice Address - Zip Code:53080
Practice Address - Country:US
Practice Address - Phone:262-284-9881
Practice Address - Fax:262-284-1174
Is Sole Proprietor?:No
Enumeration Date:2020-10-15
Last Update Date:2020-10-15
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
WI12212-40183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist