Individual
JENNIE LEE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
9655 COLORADO LN N, BROOKLYN PARK, MN 55445-2315
(763) 317-0737
Mailing address
9349 SHERIDAN AVE N, BROOKLYN PARK, MN 55444-2951
(763) 516-4386
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
125373
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
125373
—
MN
Enumeration date
02/14/2022
Last updated
02/14/2022
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