Individual
DR. JORDAN MARIE BANISTER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PHARM D.
Contact information
Practice address
1921 COBORN BLVD, SAINT CLOUD, MN 56301-2100
(701) 566-3466
Mailing address
1921 COBORN BLVD, SAINT CLOUD, MN 56301-2100
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
122411
MN
1835P2201X
Ambulatory Care Pharmacist
Primary
122411
MN
Other
Enumeration date
07/15/2015
Last updated
02/07/2025
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