Active NPI
Bryan Paulson, PHARMD
- Pharmacist
- Cloquet, MN
National Provider Identifier
1669460309
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- 117020-1
- Practice address
- 927 Trettel LN
Cloquet, MN 55720-1345 - Phone
- (218) 879-1227
- Fax
- (218) 878-3739
- NPI assigned
- Oct 6, 2005
- Sex
- Male
- 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 | 117020-1 | MN | Primary |
Addresses
Primary practice location
927 Trettel LN
Cloquet, MN 55720-1345
Mailing address
3646 E 3Rd St
Duluth, MN 55804-1814
Phone (218) 724-8636
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 |
|---|---|---|---|
| 117020-1 | MN | MD | Pharmacist |
Interoperability endpoints
- bryan.paulson.p1@direct.fonddulachsd.nextgenshare.com
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1128556800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1203984000000",
"number": "1669460309",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3646 E 3RD ST",
"city": "DULUTH",
"state": "MN",
"postal_code": "558041814",
"telephone_number": "218-724-8636"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "927 TRETTEL LN",
"city": "CLOQUET",
"state": "MN",
"postal_code": "557201345",
"telephone_number": "218-879-1227",
"fax_number": "218-878-3739"
}
],
"practiceLocations": [],
"basic": {
"last_name": "PAULSON",
"first_name": "BRYAN",
"credential": "PHARMD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2005-10-06",
"last_updated": "2008-02-26",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "MN",
"license": "117020-1",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Cloquet, MN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 26, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.