Healthcare Provider Details

I. General information

NPI: 1508928581
Provider Name (Legal Business Name): MS. CARI ANN WIEST
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/15/2006
Last Update Date: 04/23/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9 SOUTH CENTENNIAL ST
WISHEK ND
58495
US

IV. Provider business mailing address

213 S 7TH ST
WISHEK ND
58495-7311
US

V. Phone/Fax

Practice location:
  • Phone: 701-452-2368
  • Fax: 701-452-2368
Mailing address:
  • Phone: 701-452-2935
  • Fax: 701-452-2935

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License Number4790
License Number StateND

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: