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General NPI Number Information
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NPI Number | 1275145419
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Entity Type | Individual
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Provider Name | CHELSEA HUISMAN
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Gender | Female
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Dates
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Enumeration Date | 08/19/2020
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Last Update Date | 08/19/2020
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Provider Practice Location Address
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Address Line | 7435 179TH ST W
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City | LAKEVILLE
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State | MN
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Zip | 55044-5264
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Country | US
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Telephone | 952-891-5050
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Fax |
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Provider Business Mailing Address
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Address Line | 14848 CRESTVIEW AVE W
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City | ROSEMOUNT
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State | MN
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Zip | 55068-4557
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Country | US
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Telephone |
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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 | 123406
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License Number State | MN
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