Healthcare Provider Details

I. General information

NPI: 1043377617
Provider Name (Legal Business Name): DARCY LYNN PAULSEN PHARM.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 01/03/2007
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

11400 275TH ST
CHISAGO CITY MN
55013-5411
US

IV. Provider business mailing address

11400 275TH ST
CHISAGO CITY MN
55013-5411
US

V. Phone/Fax

Practice location:
  • Phone: 651-213-0023
  • Fax: 651-982-7236
Mailing address:
  • Phone: 651-213-0023
  • Fax: 651-982-7236

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License Number115758-3
License Number StateMN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: