Active NPI
Jenna Lynn Anderson, PHARMD
- Pharmacist
- Bertha, MN
National Provider Identifier
1992398788
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- 119708
- Practice address
- 124 2ND Ave NW
Bertha, MN 56437-2002 - Phone
- (218) 924-2124
- Fax
- (218) 924-2129
- NPI assigned
- Feb 12, 2021
- Last updated
- Feb 12, 2021
- Sex
- Female
- 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 | 119708 | MN | Primary |
Addresses
Primary practice location
124 2ND Ave NW
Bertha, MN 56437-2002
Mailing address
124 2ND Ave NW
Bertha, MN 56437-2002
Phone (218) 924-2124
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 |
|---|---|---|---|
| 119708 | MN | MD | Pharmacist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Seip Drug LLC | Past | Accepting new patients |
Organizations & group practices 1
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1613088000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1613088000000",
"number": "1992398788",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "124 2ND AVE NW",
"city": "BERTHA",
"state": "MN",
"postal_code": "564372002",
"telephone_number": "218-924-2124",
"fax_number": "218-924-2129"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "124 2ND AVE NW",
"city": "BERTHA",
"state": "MN",
"postal_code": "564372002",
"telephone_number": "218-924-2124",
"fax_number": "218-924-2129"
}
],
"practiceLocations": [],
"basic": {
"last_name": "ANDERSON",
"first_name": "JENNA",
"middle_name": "LYNN",
"name_prefix": "Mrs.",
"credential": "PHARMD",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2021-02-12",
"last_updated": "2021-02-12",
"certification_date": "2021-02-12",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "MN",
"license": "119708",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Bertha, MN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 12, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.