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NPI Code Detail

MEDICARE: VALERIE JEANNE WEDOE RPH

MEDICARE: VALERIE JEANNE WEDOE RPH
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1183500000XPharmacist116621MN

General Provider Information

NPI Number : 1285917484
Entity Type Code : Individual
Provider Name (Legal Business Name) : VALERIE JEANNE WEDOE RPH
Provider Business Mailing Address
First Line : 1855 SILVER BELL RD
Second Line : #120
City : EAGAN
State : MN
Zip : 55122-1178
Country : US
Telephone Number : 952-200-9597
Fax Number :
Provider Business Practice Location Address
First Line : 5801 W 16TH ST
Second Line :
City : ST LOUIS PARK
State : MN
Zip : 55416-1446
Country : US
Telephone Number : 763-582-9602
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 09/23/2011
Last Update Date : 09/23/2011

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Directions to “ VALERIE JEANNE WEDOE RPH” Practice Location

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