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General NPI Number Information
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NPI Number | 1396618104
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Entity Type | Individual
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Provider Name | BETH LOUISE VLIEGER PHARMD
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Gender | Female
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Dates
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Enumeration Date | 09/26/2025
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Last Update Date | 09/26/2025
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Provider Practice Location Address
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Address Line | 301 HIGHWAY 65 S
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City | MORA
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State | MN
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Zip | 55051-1899
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Country | US
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Telephone | 320-679-1313
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Fax |
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Provider Business Mailing Address
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Address Line | 15378 140TH ST
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City | FORESTON
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State | MN
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Zip | 56330-9541
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Country | US
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Telephone | 320-679-1313
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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 | 1835P2201X
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Taxonomy Name | Ambulatory Care Pharmacist
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License Number | 126994
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License Number State | MN
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