Individual
SAMANTHA BRENTRUP
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PHARMD
Contact information
Practice address
323 S MINNESOTA ST, CROOKSTON, MN 56716-1601
(218) 281-9420
Mailing address
426 14TH ST S, MOORHEAD, MN 56560-2958
(701) 290-9717
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
124146
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
124146
PHARMACIST LICENSE NUMBER
MN
Enumeration date
04/28/2020
Last updated
11/27/2023
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