Data from the NPPES registry. May not reflect recent changes — verify at nppes.cms.hhs.gov.
DR. TIMOTHY LEE PETERSON, PHARMD, RPH
DeactivatedDR. TIMOTHY LEE PETERSON, PHARMD, RPH is a Pharmacist healthcare provider located in WACONIA, Minnesota. NPI 1023178738 is deactivated in the NPPES registry. Verify at CMS.
Pharmacist · WACONIA, MN
This NPI has been deactivated.
The record was deactivated on April 22, 2011.
Deactivated NPIs are no longer valid for billing or credentialing. The provider may have retired, changed practice status, or had their NPI administratively deactivated.
Verify current licensure status with the NPPES NPI Registry or the relevant state medical board before relying on this record.
Registration Details
- NPI Number
- 1023178738
- Provider Type
- Individual
- Gender
- Male
- NPI Issued
- Dec 11, 2006 (4.3616438356164 yrs)
- Last Updated
- Sep 12, 2025
- Deactivated
- Apr 22, 2011
- Licenses
-
116614-7 (MN)051.040872 (IL)
Practice Information
- Address
-
875 E MAIN STWACONIA, MN, 553871081Browse MN providers · Browse ZIP 55387
- Phone
- 9524429334
- Primary Specialty
-
Pharmacist
183500000X
- Additional Specialty
- Pharmacist
Other Pharmacist Providers in WACONIA, MN
| Name | Credential | NPI |
|---|---|---|
| DR. JESSICA R BONIFAS | PHARMD | 1497752174 |
| MRS. CHRISTINA BODEM | RPH | 1639117765 |
| DR. ANNIE M HEGG | PHARM.D. | 1104033547 |
| NICHOLAS SCHUTZ | PHARM.D. | 1780973537 |
| JILL SHIPLEY | RPH | 1528352465 |
| ERIN FOSS-BEERLING | PHARMD | 1386930535 |
Data sourced from the NPPES National Provider Identifier registry. This information is for informational purposes only and is not a substitute for verifying credentials with the appropriate licensing authority. For official verification, use the NPPES NPI Registry or the relevant state medical board.