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NPI Code Detail

MEDICARE: MS. SHANNON MARIE GUTZMER PHARM D

MEDICARE: MS. SHANNON MARIE GUTZMER PHARM D
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
11835P1200XPharmacotherapy Pharmacist5199SD
21835P0018XPharmacist Clinician (PhC)/ Clinical Pharmacy Specialist5199SD

General Provider Information

NPI Number : 1265529572
Entity Type Code : Individual
Provider Name (Legal Business Name) : MS. SHANNON MARIE GUTZMER PHARM D
Provider Business Mailing Address
First Line : 3002 COUNTRY CLUB CT
Second Line :
City : RAPID CITY
State : SD
Zip : 57702-5287
Country : US
Telephone Number : 605-484-4777
Fax Number :
Provider Business Practice Location Address
First Line : 2165 PROMISE RD
Second Line :
City : RAPID CITY
State : SD
Zip : 57701-8981
Country : US
Telephone Number : 605-718-1095
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 10/06/2006
Last Update Date : 12/31/2024

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