JACOB HENRICKSEN PHARMD
NPI 1265037188
Pharmacist in Kenosha, WI

Active since November 30, 2020
3726 22ND AVE, KENOSHA, WI 53140(262) 654-6545 Get Directions Write a Review

NPPES record last updated: November 30, 2020. Verified against the NPPES registry weekly; last sync: August 09, 2026.

About Jacob Henricksen Pharmd NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

JACOB HENRICKSEN PHARMD (NPI 1265037188) is an individual pharmacist in Kenosha, Wisconsin, licensed in Wisconsin (20472-40) and active in the NPI registry since November 2020.

NPPES Registry Identity

NPI1265037188
Entity TypeIndividualMale
Primary Taxonomy183500000X
Provider Legal NameJACOB HENRICKSENCredential: PHARMD
Location Address3726 22ND AVEKenosha, WI 53140-5300
Mailing Address11221 Synergy Dr Apt 366Wauwatosa, WI 53222-1351 · (763) 202-9618
Sole ProprietorYes
Enumeration DateNovember 30, 2020
NPPES CertifiedNovember 22, 2020
NPI 1265037188 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

Primary SpecialtyPharmacistPharmacy Service Providers
Taxonomy Code183500000X
License Licensed in WI · 20472-40
Definition
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.
3726 22ND AVE, Kenosha, WI 53140

Group Practice 1

Group TaxonomyThis provdier is a business group of one or more individual practitioners, all of who practice with the same area of specialization.193400000X SINGLE SPECIALTY GROUP

Other Providers at the Same Location NPPES 4

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

Pharmacist
3726 22ND AVE
KENOSHA, WI 53140
Pharmacy
3726 22ND AVE
KENOSHA, WI 53140
Pharmacist
3726 22ND AVE
KENOSHA, WI 53140
Pharmacist
3726 22ND AVE
KENOSHA, WI 53140

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Jacob Henricksen's NPI number?

The NPI number for Jacob Henricksen is 1265037188. It was assigned to this individual provider in the NPPES registry on November 30, 2020.

Where is Jacob Henricksen located?

Jacob Henricksen practices at 3726 22nd Ave, Kenosha, WI 53140. The listed phone number is (262) 654-6545.

What is Jacob Henricksen's specialty?

The primary specialty registered for this NPI is Pharmacist with taxonomy code 183500000X.

When was this NPI record last updated?

The NPPES record for Jacob Henricksen was last updated on November 30, 2020. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 5 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.