BRENDA MARIE PEDERSON


Address: 6616 Union Lake Trl, Lonsdale, MN 55046-4324
Phone: 5077442958

BRENDA MARIE PEDERSON (NPI# 1801118955) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).

Provider Overview

Nation Provider ID (NPI) 1801118955
Entity Type Individual
Full Name BRENDA MARIE PEDERSON
Credential RPH
Practice Address 6616 Union Lake Trl
Lonsdale
MN 55046-4324
Practice Telephone 5077442958
Practice Fax Number 5077445894
Mailing Telephone 5077442958
Mailing Fax Number 5077445894
Enumeration Date 2010-02-17
Last Update Date 2010-02-17
Gender Code F
Is Sole Proprietor Y

Taxonomy

Primary Taxonomy Code Classification License Number License State Taxonomy Group
Y 1835G0303X Pharmacist
Specialization: Geriatric
114314 MN Pharmacy Service Providers

Other Provider Identifier

State Issuer Identifier Type Code
MN PHARMACIST LICENSE NUMBER 114314 01

Office Location

Street Address 6616 UNION LAKE TRL
City LONSDALE
State MN
Zip Code 55046-4324

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1053393777 Red Wing Health Center, LLC Skilled Nursing Facility 1412 West 4th Street, Red Wing, MN 55046 2005-11-17
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1154586634 Lonsdale Chiropractic Chiropractor 100 Main St So, Lonsdale, MN 55046-0162 2008-07-23
1699854513 Bruce H Lieske Chiropractor 100 Main Street South, Lonsdale, MN 55046-0162 2006-11-02
1275923856 William Raymond Lieske Chiropractor 100 Main Street South, Lonsdale, MN 55046-0162 2015-02-03
1700948577 Rhonda Lynn Meyer Nurse Practitioner 103-15th Ave Se, Family Health Medical Clinic Lonsdale, Lonsdale, MN 55046-5001 2006-12-15
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Taxonomy Information

Taxonomy Code 1835G0303X
Grouping Pharmacy Service Providers
Classification Pharmacist
Specialization Geriatric

Taxonomy Definition

A pharmacist who is certified in geriatric pharmacy practice is designated as a "Certified Geriatric Pharmacist" (CGP). To become certified, candidates are expected to be knowledgeable about principles of geriatric pharmacotherapy and the provision of pharmaceutical care to the elderly.
Notes: Source: Commission for Certification in Geriatric Pharmacy (www.ccgp.org) [7/1/2006: new]

Providers in the same taxonomy and state

NPI Name Taxonomy Address Enumeration
1891301768 Brian Haug Pharmacist 12083 Scenic River Dr, Baxter, MN 56425-8399 2020-09-16
1659856094 William Frank Vouk IIi Pharmacist 1017 N 19th Ave E, Duluth, MN 55812-1127 2018-10-02
1962994186 Neil Peter Thompson Pharmacist 4048 19th Ave S, Minneapolis, MN 55407-3402 2018-06-04
1154822617 John Travis Hansen Pharmacist 40 Crusader Ave W, West St Paul, MN 55118-4425 2018-02-21
1104325075 Patty Ann Doyle Pharmacist 8712 Sandro Rd, Bloomington, MN 55438-1229 2018-02-06
1679990857 Jodie Little Pharmacist 801 W. Central Entrance, Shopko Pharmacy 2114, Duluth, MN 55811 2014-03-25
1043581416 Matthew John Schille Pharmacist 1509 10th Ave South, Suite 16, Minneapolis, MN 55404 2012-01-18
1477834976 Richard Allen Hasher Pharmacist 425 Wabasha St N, Saint Paul, MN 55102-1108 2011-08-30
1437211141 Dean Ray Schmiedt Pharmacist 24411 147th Ave, Fort Ripley, MN 56449-2107 2006-12-16
1942763834 Stephanie Loegering Pharmacist 430 W State Highway 5, Waconia, MN 55387-1723 2019-04-09
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Competitor

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City LONSDALE
Zip Code 55046

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Dataset Information

Data Provider Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES)
Jurisdiction Medicare & Medicaid

This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.

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