Individual
SUSAN JANE NILSEN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
RPH
Contact information
Practice address
201 CALUMET AVE, DESMET, SD 57231
(605) 854-3861
Mailing address
103 14TH ST NE, WATERTOWN, SD 57201-2818
(605) 886-2830
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
3599
ND
183500000X
Pharmacist
Primary
R4739
SD
Other
Enumeration date
02/21/2007
Last updated
07/08/2007
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