MEDICARE: DR. KIRSTEN M GULDEN PHARMD

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	116812	MN

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1508141730
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. KIRSTEN M GULDEN PHARMD

Provider Business Mailing Address
First Line	:	7940 PENN AVE S
Second Line	:
City	:	BLOOMINGTON
State	:	MN
Zip	:	55431-1315
Country	:	US
Telephone Number	:	952-252-1154
Fax Number	:	952-252-1157

Provider Business Practice Location Address
First Line	:	7940 PENN AVE S
Second Line	:
City	:	BLOOMINGTON
State	:	MN
Zip	:	55431-1315
Country	:	US
Telephone Number	:	952-252-1154
Fax Number	:	952-252-1157

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

Provider Enumeration Date	:	10/19/2011
Last Update Date	:	10/19/2011

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