Healthcare Provider Details

I. General information

NPI: 1588801344
Provider Name (Legal Business Name): LEANNE MARIE HULM PHARMD, RPH
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: LEANNE MARIE RATHJEN

II. Dates (important events)

Enumeration Date: 01/15/2009
Last Update Date: 01/15/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

835 S WASHINGTON ST SUITE 2
BISMARCK ND
58504-5416
US

IV. Provider business mailing address

835 S WASHINGTON ST SUITE 2
BISMARCK ND
58504-5416
US

V. Phone/Fax

Practice location:
  • Phone: 701-223-1656
  • Fax: 701-223-9628
Mailing address:
  • Phone: 701-223-1656
  • Fax: 701-223-9628

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License Number5129
License Number StateND

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: