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General NPI Number Information
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NPI Number | 1174861272
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Entity Type | Individual
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Provider Name | YAJING LI PHARMD
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Gender | Female
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Dates
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Enumeration Date | 01/24/2013
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Last Update Date | 01/24/2013
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Provider Practice Location Address
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Address Line | 1925 WEST COUNTY ROAD B2
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City | ROSEVILLE
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State | MN
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Zip | 55113
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Country | US
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Telephone | 612-666-1670
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Fax |
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Provider Business Mailing Address
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Address Line | 12480 CORNELL CT
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City | EDEN PRAIRIE
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State | MN
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Zip | 55347
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Country | US
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Telephone | 952-946-8776
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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 | 119682
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License Number State | MN
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