NPI 1003462540

Louise Ballam Peterson

Practitioner Pharmacist Minneapolis, MN

Practice location

Address: 2801 Nicollet Ave, Minneapolis, MN 55408-2329
Phone: (612) 873-7801

Registered specialties

Pharmacist Primary

Pharmacy Service Providers Taxonomy 183500000X Licence 120240 (MN)

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Registry record

NPI: 1003462540
Entity type: Individual
Sex (as registered): Female
NPI issued: 12 Aug 2019
Record last updated: 12 Aug 2019

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.