Individual
JAMES NISSEN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
2000 CLIFF LAKE RD, EAGAN, MN 55122-2400
(651) 688-8947
Mailing address
2000 CLIFF LAKE RD, EAGAN, MN 55122-2400
(651) 688-8947
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
111586
MN
Other
Enumeration date
06/14/2011
Last updated
06/14/2011
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