Individual
KAITLIN MARIE BOURGEOIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PHARMD
Contact information
Practice address
153 CESAR CHAVEZ ST, SAINT PAUL, MN 55107-2226
(651) 602-7500
Mailing address
180 COUNTY ROAD B2 E APT 35, LITTLE CANADA, MN 55117-1517
(763) 302-9624
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
126070
MN
Other
Enumeration date
08/04/2023
Last updated
01/16/2025
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