Individual
JENNIFER S IVERSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RPH
Contact information
Practice address
301 NP AVE N, FARGO, ND 58102-4835
(701) 271-1495
Mailing address
301 NP AVE N, FARGO, ND 58102-4835
(701) 271-1495
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
4966
ND
Other
Enumeration date
03/16/2007
Last updated
11/02/2012
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