MEDICARE: NANCY RENEE SCORE

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
1	183500000X	Pharmacist	113981	MN

General Provider Information

NPI Number	:	1376149450
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	NANCY RENEE SCORE

Provider Business Mailing Address
First Line	:	18400 ORCHARD TRL APT 354
Second Line	:
City	:	LAKEVILLE
State	:	MN
Zip	:	55044-5315
Country	:	US
Telephone Number	:	612-202-6122
Fax Number	:	952-435-2072

Provider Business Practice Location Address
First Line	:	17756 KENWOOD TRL
Second Line	:
City	:	LAKEVILLE
State	:	MN
Zip	:	55044-9454
Country	:	US
Telephone Number	:	952-435-0542
Fax Number	:	952-435-2072

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	12/05/2020
Last Update Date	:	11/21/2025

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