Christine Jill Etter, RPH
Individual provider Active NPI Pharmacist · Roseville, MN
NPI 1821374331 · NPPES record last updated Oct 28, 2011
Key facts
- NPI
- 1821374331
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Pharmacist 183500000X
- License
- 114389 (MN)
- Practice address
- 2635 Rice St
Roseville, MN 55113-3717 - Phone
- (651) 483-3976
- Fax
- (651) 483-0064
- NPI assigned
- Oct 28, 2011
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 2
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
- Credentials
- Registered Pharmacist
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 114389 | MN | MD | Pharmacist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Walgreen Co | Past |
Accepting new patients | |
| Walgreen Co | Past | Accepting new patients |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pharmacist | 183500000X | 114389 | MN | Yes |
Addresses
Primary practice location
2635 Rice St
Roseville, MN 55113-3717
Mailing address
2635 Rice St
Roseville, MN 55113-3717
Phone (651) 483-3976
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 Oct 28, 2011. 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.