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General NPI Number Information
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NPI Number | 1477145464
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Entity Type | Individual
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Provider Name | AMY PATRICIA TESTER PHARM D
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Gender | Female
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Dates
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Enumeration Date | 02/10/2021
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Last Update Date | 02/10/2021
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Provider Practice Location Address
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Address Line | 419 SKYLINE BLVD
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City | CLOQUET
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State | MN
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Zip | 55720-1164
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Country | US
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Telephone | 218-879-1501
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Fax | 218-879-4661
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Provider Business Mailing Address
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Address Line | 419 SKYLINE BLVD
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City | CLOQUET
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State | MN
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Zip | 55720-1164
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Country | US
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Telephone | 218-879-1501
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Fax | 218-879-4661
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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 | 117696
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License Number State | MN
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