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Individual

MS. SUSAN JANE CANNIFF

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
RPH

Contact information

Practice address
2099 FORD PKWY, SAINT PAUL, MN 55116-1814
(651) 414-3882
(651) 414-3888
Mailing address
2099 FORD PKWY, SAINT PAUL, MN 55116-1814
(651) 414-3882
(651) 414-3888

Taxonomy

Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
119903
MN
183500000X
Pharmacist
12485
CO

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
119903
MINNESOTA PHARMACY LICENSE NUMBER
MN
01
12485
PHARMACIST LICENSE
CO
Enumeration date
11/30/2011
Last updated
11/30/2011
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