Individual
DR. JAN E. PEDERSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PHARM.D.
Contact information
Practice address
215 PENNINGTON AVE, PHARMACY, THIEF RIVER FALLS, MN 56701-2900
(218) 681-1515
Mailing address
21096 GOLD COAST RD NW, BEMIDJI, MN 56601-9180
(218) 686-5562
(218) 681-2330
Taxonomy
Speciality
Code
Description
License number
State
1835P0018X
Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist
Primary
116988
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
743688200
—
MN
Enumeration date
03/21/2007
Last updated
05/08/2020
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