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General NPI Number Information
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NPI Number | 1699258970
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Entity Type | Individual
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Provider Name | JOANNA LEE MAKI PHARMD, RPH
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Gender | Female
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Dates
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Enumeration Date | 09/12/2018
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Last Update Date | 03/04/2021
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Provider Practice Location Address
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Address Line | 1216 2ND ST SW STE M600B
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City | ROCHESTER
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State | MN
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Zip | 55902-1906
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Country | US
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Telephone | 507-775-5731
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Fax |
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Provider Business Mailing Address
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Address Line | 123 6TH AVE SE APT 308
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City | ROCHESTER
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State | MN
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Zip | 55904-4830
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Country | US
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Telephone | 651-472-1912
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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 | 123997
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License Number State | MN
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