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General NPI Number Information
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NPI Number | 1366807810
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Entity Type | Individual
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Provider Name | BETH WILMUNEN PHARMD
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Gender | Female
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Dates
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Enumeration Date | 12/29/2015
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Last Update Date | 12/29/2015
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Provider Practice Location Address
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Address Line | 328 W CONAN ST
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City | ELY
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State | MN
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Zip | 55731-1145
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Country | US
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Telephone | 218-365-8750
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Fax | 218-365-8789
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Provider Business Mailing Address
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Address Line | 328 W CONAN ST
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City | ELY
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State | MN
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Zip | 55731-1145
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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 | 121381
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License Number State | MN
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Taxonomy #2
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Taxonomy Code | 183500000X
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Taxonomy Name | Pharmacist
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License Number | 17104
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License Number State | WI
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