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General NPI Number Information
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NPI Number | 1386740132
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Entity Type | Individual
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Provider Name | JENNIFER MCNUTT RPH
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Gender | Female
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Dates
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Enumeration Date | 09/16/2006
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 401 COUNTY ROAD 42 E
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City | BURNSVILLE
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State | MN
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Zip | 55306-5706
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Country | US
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Telephone | 952-435-8145
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Fax | 952-435-5513
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Provider Business Mailing Address
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Address Line | 7988 HALLMARK WAY
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City | APPLE VALLEY
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State | MN
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Zip | 55124-7185
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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 | 116210-9
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License Number State | MN
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