Individual
MRS. TRACY ELIZABETH SAMSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RPH
Contact information
Practice address
24 3RD ST NE, OSSEO, MN 55369-1212
(763) 493-5242
(763) 493-2621
Mailing address
15681 84TH PL N, MAPLE GROVE, MN 55311-1560
(763) 420-7861
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
116412-3
MN
183500000X
Pharmacist
3861
ND
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2418526
NABP
MN
Enumeration date
06/06/2007
Last updated
07/08/2007
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