Active NPI
Bridgette Olutosin Teniola, PHARMD
- Pharmacist
- Otsego, MN
National Provider Identifier
1376131771
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- 124964
- Practice address
- 15800 87TH St NE
Otsego, MN 55330-6546 - Phone
- (763) 252-1316
- NPI assigned
- Jan 2, 2021
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pharmacist | 183500000X | 124964 | MN | Primary |
Addresses
Primary practice location
15800 87TH St NE
Otsego, MN 55330-6546
Mailing address
8400 Bass Lake Rd Apt 352
New Hope, MN 55428-5348
Phone (954) 980-2733
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
- Credentials
- Doctor of Pharmacy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 124964 | MN | MD | Pharmacist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1609545600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1609545600000",
"number": "1376131771",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "8400 BASS LAKE RD APT 352",
"city": "NEW HOPE",
"state": "MN",
"postal_code": "554285348",
"telephone_number": "954-980-2733"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "15800 87TH ST NE",
"city": "OTSEGO",
"state": "MN",
"postal_code": "553306546",
"telephone_number": "763-252-1316"
}
],
"practiceLocations": [],
"basic": {
"last_name": "TENIOLA",
"first_name": "BRIDGETTE",
"middle_name": "OLUTOSIN",
"credential": "PHARMD",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2021-01-02",
"last_updated": "2021-01-02",
"certification_date": "2021-01-02",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "MN",
"license": "124964",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Otsego, MN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 2, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.