Kerry Lynn Anderson, PHARMD, RPH
Individual provider Active NPI Pharmacist · Roseville, MN
NPI 1457783375 · NPPES record last updated Nov 25, 2024
Key facts
- NPI
- 1457783375
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Pharmacist 183500000X
- License
- 123479 (MN)
- Practice address
- 2720 Fairview Ave N Ste 200
Roseville, MN 55113-1306 - Phone
- (651) 633-6883
- NPI assigned
- Aug 1, 2013
- 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
- Doctor of Pharmacy, Registered Pharmacist
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 123479 | MN | MD | Pharmacist |
| PH60389148 | WA | MD | Pharmacist |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pharmacist | 183500000X | PH60389148 | WA | |
| Pharmacist | 183500000X | 123479 | MN | Yes |
Addresses
Primary practice location
2720 Fairview Ave N Ste 200
Roseville, MN 55113-1306
Mailing address
4161 Cashell GLN
Eagan, MN 55122-2819
Phone (630) 302-8582
Other providers in Roseville, MN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Nov 25, 2024. 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.