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General NPI Number Information
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NPI Number | 1851046205
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Entity Type | Individual
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Provider Name | TODD PAUL NELSON RPH
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Gender | Male
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Dates
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Enumeration Date | 02/15/2022
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Last Update Date | 02/15/2022
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Provider Practice Location Address
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Address Line | 161 GLEN STREET
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City | FOLEY
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State | MN
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Zip | 56329
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Country | US
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Telephone | 320-968-8625
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Fax | 320-968-4055
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Provider Business Mailing Address
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Address Line | 1010 HILLSIDE RD
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City | SAUK RAPIDS
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State | MN
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Zip | 56379-2577
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Country | US
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Telephone | 320-339-1481
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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 | 117125
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License Number State | MN
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