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General NPI Number Information
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NPI Number | 1871758169
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Entity Type | Individual
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Provider Name | ALISSA CAROLINE KEENE PHARM.D
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Gender | Female
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Dates
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Enumeration Date | 07/25/2008
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Last Update Date | 05/19/2025
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Provider Practice Location Address
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Address Line | 4801 VETERANS DR
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City | SAINT CLOUD
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State | MN
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Zip | 56303-2015
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Country | US
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Telephone | 320-255-6345
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Fax |
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Provider Business Mailing Address
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Address Line | 6799 COVE RD NW
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City | SAUK RAPIDS
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State | MN
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Zip | 56379-4599
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Country | US
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Telephone | 320-420-8737
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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 | 119376
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License Number State | MN
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Taxonomy #2
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Taxonomy Code | 1835P1200X
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Taxonomy Name | Pharmacotherapy Pharmacist
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License Number | 119376
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License Number State | MN
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