Shanise Wallace is a Pharmacist based in Kenosha, WI. Shanise Wallace practices in Kenosha, WI. The NPI Number for Shanise Wallace is 1114552445 and holds a License No. 17696-40 (Wisconsin).
The current practice location address for Shanise Wallace is 3710 57Th Ave, Kenosha, WI and can be reached out via phone at 262-652-1474.
Location: 3710 57Th Ave, Kenosha, WI, 53144-4820
Provider Profile Details
NPI Number
1114552445
Provider Name
Shanise Wallace
Credential
Provider Entity Type
Individual
Gender
Female
Address
3710 57Th Ave, Kenosha, WI, 53144-4820
Phone Number
262-652-1474
Fax Number
Provider Enumeration Date
03/06/2020
Last Update Date
03/10/2024
Provider Business Practice Location Address Details
Address
3710 57Th Ave
City
State
Zip
53144-4820
Phone Number
262-652-1474
Fax Number
Provider Business Mailing Address Details
Address
3710 57Th Ave
City
State
Zip
53144-4820
Phone Number
262-652-1474
Fax Number
Provider's Taxonomy Details 1
Type
Pharmacy Service Providers
Classification
Pharmacist
Speciality
-
Taxonomy
License No.
17696-40 (Wisconsin)
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.
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