Alyssa Boesche, PHARMD
Individual provider Active NPI Pharmacist · Glencoe, MN
NPI 1609555283 · NPPES record last updated Jul 12, 2023
Key facts
- NPI
- 1609555283
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Pharmacist 183500000X
- License
- 125133 (MN)
- Practice address
- 1805 Hennepin Ave N
Glencoe, MN 55336-1416 - Phone
- (320) 864-3121
- NPI assigned
- Jul 12, 2023
- 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
- Credentials
- Doctor of Pharmacy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 125133 | MN | MD | Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist | 1835P0018X | 125133 | MN | |
| Pharmacist | 183500000X | 125133 | MN | Yes |
Addresses
Primary practice location
1805 Hennepin Ave N
Glencoe, MN 55336-1416
Mailing address
1805 Hennepin Ave N
Glencoe, MN 55336-1416
Phone (320) 864-3121
Other providers in Glencoe, MN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jul 12, 2023. 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.