Individual
BRENDA MARIE PEDERSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
RPH
Contact information
Practice address
6616 UNION LAKE TRL, LONSDALE, MN 55046-4324
(507) 744-2958
(507) 744-5894
Mailing address
6616 UNION LAKE TRL, LONSDALE, MN 55046-4324
(507) 744-2958
(507) 744-5894
Taxonomy
Speciality
Code
Description
License number
State
1835G0303X
Geriatric Pharmacist
Primary
114314
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
114314
PHARMACIST LICENSE NUMBER
MN
Enumeration date
02/17/2010
Last updated
02/17/2010
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