Individual
LISA MARIE GABRIELSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
9925 HUDSON PL, WOODBURY, MN 55125-9461
(651) 702-7980
(651) 702-7983
Mailing address
11208 WHITEWATER DR, WOODBURY, MN 55129-5309
(701) 893-8607
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
120451
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
120451
MN BOARD OF PHARMACY
MN
Enumeration date
04/13/2019
Last updated
04/13/2019
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