Healthcare Provider Details

I. General information

NPI: 1275813891
Provider Name (Legal Business Name): KATHERINE DEERING PHARM D
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/26/2011
Last Update Date: 08/26/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

703 E MAIN ST
ALBERT LEA MN
56007-2937
US

IV. Provider business mailing address

325 HOFFMAN DR APT 312
OWATONNA MN
55060-3276
US

V. Phone/Fax

Practice location:
  • Phone: 507-369-0260
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License Number120064
License Number StateMN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: