Mary Catherine Gustafson, PHARMD

Primary specialty

Pharmacist Clinician (PhC)/ Clinical Pharmacy SpecialistTaxonomy code 1835P0018X

License

115775 Issued in MN

Practice address

345 Smith Ave N
Saint Paul, MN 55102-2346

Phone

(651) 220-6969

NPI assigned

May 18, 2011

Last updated

May 18, 2011By the provider in NPPES

Sex

Female

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Doctor of Pharmacy

State licenses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1305676800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1305676800000",
    "number": "1568755940",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "345 SMITH AVE N",
            "city": "SAINT PAUL",
            "state": "MN",
            "postal_code": "551022346",
            "telephone_number": "651-220-6969"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "345 SMITH AVE N",
            "city": "SAINT PAUL",
            "state": "MN",
            "postal_code": "551022346",
            "telephone_number": "651-220-6969"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GUSTAFSON",
        "first_name": "MARY",
        "middle_name": "CATHERINE",
        "name_prefix": "Mrs.",
        "credential": "PHARMD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2011-05-18",
        "last_updated": "2011-05-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1835P0018X",
            "taxonomy_group": "",
            "desc": "Pharmacist, Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist",
            "state": "MN",
            "license": "115775",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Allison Anne Guse, MSW, LICSW
• David H Gustafson, MD
• Gayl L Gustafson, MD
• Ginger Celeste Gustafson
• Kevin Gustafson, M.D.
• Katherine F Guthrie, MD
• Margaret L Guthrie, MD
• Ramana Kristi Gutierrez, OTR
• Guled Mohamed Guulleed
• Christine Guy, M.A.

• Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist in Saint Paul, MN
• Providers in Saint Paul, MN by specialty
• Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 18, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.