Karen H Mattson, R PH
Individual provider Active NPI Pharmacist · Buffalo, MN
NPI 1104039296 · NPPES record last updated Jul 8, 2007
Key facts
- NPI
- 1104039296
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Pharmacist 183500000X
- License
- 112577 (MN)
- Practice address
- 1008 Highway 55 E
Buffalo, MN 55313-8923 - Phone
- (763) 682-5828
- NPI assigned
- May 7, 2007
- Sex
- Female
- Sole proprietor
- Yes
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
- Credentials
- Registered Pharmacist
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 112577 | MN | MD | Pharmacist |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pharmacist | 183500000X | 112577 | MN | Yes |
Addresses
Primary practice location
1008 Highway 55 E
Buffalo, MN 55313-8923
Mailing address
1855 Bolton Dr NW
Buffalo, MN 55313-4404
Phone (763) 682-5179
Other providers in Buffalo, MN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jul 8, 2007. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.