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Data from the NPPES registry. May not reflect recent changes — verify at nppes.cms.hhs.gov.

SAMANTHA GUSTAFSON

Active Sole Proprietor

Pharmacist Clinician (PhC) · RED LAKE, MN

Registration Details

NPI Number
1326334525
Provider Type
Individual
Gender
Female
NPI Issued
Jun 26, 2011 (14.839236399242 yrs)
Last Updated
May 11, 2020
Licenses
119413 (MN)
119413 (MN)
Sole Proprietor
Yes

Practice Information

Address
24760 HOSPITAL DRIVE
RED LAKE, MN, 56671
Browse MN providers · Browse ZIP 56671
Phone
2186792825
Primary Specialty
Pharmacist Clinician (PhC)
1835P0018X
Additional Specialty
Pharmacist Clinician (PhC)

Other Pharmacist Clinician (PhC) Providers in RED LAKE, MN

Name Credential NPI
MRS. TERESA RENAE GRUND R.PH 1639152119
MRS. KAILEE LYNN FRETLAND PHARM D 1730291907
MRS. CHRISTEL SVINGEN PHARM. D. 1609990027
DR. SHANI LEE SHRIVER PHARM.D. 1851617773
STEPHANIE ERIN GLESSING PHARM.D. 1275822199
ALLAN DEMUTH 1689092983
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.