Individual
MYRNA KAY ANDERSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
R.PH.
Contact information
Practice address
400 BURDICK EXPY E, MINOT, ND 58701-4768
(701) 857-7900
(701) 857-7834
Mailing address
1823 15 1/2 ST SW, MINOT, ND 58701-6184
(701) 839-2286
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
3056
ND
1835N1003X
Nutrition Support Pharmacist
3056
ND
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1093764599
NPI
ND
05
—
20121
—
ND
Enumeration date
01/07/2009
Last updated
01/07/2009
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