Shawna Wiser
Individual provider Active NPI Pharmacist · Dilworth, MN
NPI 1144829862 · NPPES record last updated Oct 23, 2020
Key facts
- NPI
- 1144829862
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Pharmacist 183500000X
- License
- 119408 (MN)
- Practice address
- 415 34TH St N
Dilworth, MN 56529-1801 - Phone
- (218) 233-9833
- NPI assigned
- Oct 23, 2020
- Sex
- Female
- Sole proprietor
- No
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 119408 | MN | MD | Pharmacist |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pharmacist | 183500000X | 119408 | MN | Yes |
Addresses
Primary practice location
415 34TH St N
Dilworth, MN 56529-1801
Mailing address
1108 41St Ave N
Fargo, ND 58102-5302
Other providers in Dilworth, MN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Oct 23, 2020. 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.