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General NPI Number Information
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NPI Number | 1104104173
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Entity Type | Individual
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Provider Name | CLAIRE MARIE FERNAN PHARMD
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Gender | Female
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Dates
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Enumeration Date | 07/25/2011
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Last Update Date | 07/25/2011
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Provider Practice Location Address
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Address Line | 345 SMITH AVE N
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City | SAINT PAUL
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State | MN
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Zip | 55102-2346
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Country | US
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Telephone | 651-220-6962
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Fax |
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Provider Business Mailing Address
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Address Line | 5480 BLACKBERRY TRL APT 334
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City | INVER GROVE HEIGHTS
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State | MN
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Zip | 55076-1217
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Country | US
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Telephone | 608-487-0685
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 183500000X
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Taxonomy Name | Pharmacist
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License Number | 120416
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License Number State | MN
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