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General NPI Number Information
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NPI Number | 1215457338
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Entity Type | Individual
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Provider Name | KIRSTIN M GRAMITH PHARMD
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Gender | Female
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Dates
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Enumeration Date | 06/20/2017
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Last Update Date | 06/20/2017
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Provider Practice Location Address
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Address Line | 420 E 1ST ST
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City | DULUTH
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State | MN
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Zip | 55805-1901
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Country | US
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Telephone | 218-786-2151
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Fax |
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Provider Business Mailing Address
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Address Line | 1702 UNIVERSITY DR S MEDICAL STAFF SERVICES SSC
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City | FARGO
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State | ND
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Zip | 58103-4940
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Country | US
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Telephone | 701-364-8177
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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 | PENDING
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License Number State | MN
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