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General NPI Number Information
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NPI Number | 1134854920
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Entity Type | Individual
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Provider Name | ANNA CLAIRE MCCUSKER NEIN PHARMD
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Gender | Female
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Dates
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Enumeration Date | 07/18/2022
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Last Update Date | 12/05/2024
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Provider Practice Location Address
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Address Line | 211 MARKET DR STE C
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City | PERHAM
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State | MN
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Zip | 56573-2125
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Country | US
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Telephone | 218-346-4840
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Fax | 877-795-9596
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Provider Business Mailing Address
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Address Line | 321 HIGHWAY 10 W
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City | DETROIT LAKES
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State | MN
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Zip | 56501-3046
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Country | US
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Telephone | 218-847-9248
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Fax | 218-847-8874
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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 | 125682
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License Number State | MN
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