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NPI Code Detail

MEDICARE: DR. DEANNA M GENGLER

MEDICARE:  DR. DEANNA M GENGLER
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 Pharmacist117513-8MN

General Provider Information

NPI Number : 1518936434
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. DEANNA M GENGLER
Provider Business Mailing Address
First Line : 256 9TH AVE S
Second Line :
City : SOUTH ST PAUL
State : MN
Zip : 55075-2212
Country : US
Telephone Number : 651-255-2548
Fax Number :
Provider Business Practice Location Address
First Line : 153 CESAR CHAVEZ ST
Second Line :
City : SAINT PAUL
State : MN
Zip : 55107-2226
Country : US
Telephone Number : 651-602-7589
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/14/2006
Last Update Date : 07/08/2007

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Directions to “ DR. DEANNA M GENGLER ” Practice Location

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