Provider Demographics
NPI:1306721519
Name:NORDER, MICHAEL JOHN (RPH)
Entity type:Individual
Prefix:
First Name:MICHAEL
Middle Name:JOHN
Last Name:NORDER
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 1:10829 COLOMBUS DR
Mailing Address - Street 2:
Mailing Address - City:FERRYVILLE
Mailing Address - State:WI
Mailing Address - Zip Code:54628-8167
Mailing Address - Country:US
Mailing Address - Phone:262-483-2553
Mailing Address - Fax:
Practice Address - Street 1:109 N MARQUETTE RD
Practice Address - Street 2:
Practice Address - City:PRAIRIE DU CHIEN
Practice Address - State:WI
Practice Address - Zip Code:53821-1512
Practice Address - Country:US
Practice Address - Phone:608-326-0581
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-08-07
Last Update Date:2025-08-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI109842-401835P2201X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1835P2201XPharmacy Service ProvidersPharmacistAmbulatory Care