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NPI Code Detail

MEDICARE: MISS MOLLI ROSE JANNETTE PHARM.D.

MEDICARE:  MISS MOLLI ROSE JANNETTE  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
1183500000XPharmacist5130ND
2183500000XPharmacist118953MN

General Provider Information

NPI Number : 1972702090
Entity Type Code : Individual
Provider Name (Legal Business Name) : MISS MOLLI ROSE JANNETTE PHARM.D.
Provider Business Mailing Address
First Line : 15245 BLUEBIRD ST NW
Second Line :
City : ANDOVER
State : MN
Zip : 55304-3538
Country : US
Telephone Number : 763-434-1901
Fax Number :
Provider Business Practice Location Address
First Line : 15245 BLUEBIRD ST NW
Second Line :
City : ANDOVER
State : MN
Zip : 55304-3538
Country : US
Telephone Number : 763-434-1901
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/18/2007
Last Update Date : 02/12/2020

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Directions to “ MISS MOLLI ROSE JANNETTE PHARM.D.” Practice Location

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These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.