Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

Jacob Henricksen, PHARMD

Individual provider Pharmacist · NPI 1265037188

Jacob Henricksen, PHARMD is a Pharmacist in Kenosha, Wisconsin. Practices as a sole proprietor. Licensed in Wisconsin.

Licensed in
WI
In the registry since
2020
What do these letters mean?
PHARMD — Doctor of Pharmacy
The professional degree required to practise as a pharmacist in the United States.

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Practice location Address checks out

3726 22nd Ave
Kenosha, WI 53140-5300
Phone: (262) 654-6545
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Pharmacist (primary) Taxonomy 183500000X · Licence 20472-40 (WI)

Record details

NPI number1265037188
Entity typeIndividual (Type 1)
GenderMale
Credentials PHARMD
Sole proprietorYes
NPI enumeratedNovember 30, 2020
Last updated in NPPESNovember 30, 2020
Certification dateNovember 22, 2020
Mailing address11221 Synergy Dr Apt 366, Wauwatosa, WI 53222-1351

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