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General NPI Number Information
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NPI Number | 1558369322
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Entity Type | Individual
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Provider Name | NICOLE LYNNE PATERSON PHARM.D. BCPS
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Gender | Female
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Dates
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Enumeration Date | 07/14/2005
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Last Update Date | 03/09/2019
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Provider Practice Location Address
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Address Line | 3305 CENTRAL PARK VILLAGE DR
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City | EAGAN
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State | MN
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Zip | 55121-7707
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Country | US
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Telephone | 651-406-8860
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Fax |
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Provider Business Mailing Address
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Address Line | 16116 INVERNESS WAY
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City | LAKEVILLE
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State | MN
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Zip | 55044-4620
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Country | US
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Telephone | 952-953-9171
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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 | 1835P1200X
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Taxonomy Name | Pharmacotherapy Pharmacist
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License Number | 1164563
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License Number State | MN
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