Healthcare Provider Details

I. General information

NPI: 1528372596
Provider Name (Legal Business Name): PATRICK JON NETLAND PHARMD
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/02/2010
Last Update Date: 12/12/2025
Certification Date: 12/12/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2101 ELM ST N 119 PHARMACY
FARGO ND
58102-2417
US

IV. Provider business mailing address

2101 ELM ST N 119 PHARMACY
FARGO ND
58102-2417
US

V. Phone/Fax

Practice location:
  • Phone: 701-232-3241
  • Fax:
Mailing address:
  • Phone: 701-232-3241
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1835P1200X
TaxonomyPharmacotherapy Pharmacist
License Number119700
License Number StateMN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: