Individual
STEPHANIE ANNE PETERSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PHARMD
Contact information
Practice address
8201 OLD CARRIAGE CT, SHAKOPEE, MN 55379-3154
(952) 496-2982
Mailing address
5699 193RD ST E, PRIOR LAKE, MN 55372-3119
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
123799
MN
Other
Enumeration date
07/06/2018
Last updated
07/08/2020
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