Provider Demographics
NPI:1134090350
Name:PEDERSEN, KAREN
Entity type:Individual
Prefix:
First Name:KAREN
Middle Name:
Last Name:PEDERSEN
Suffix:
Gender:X
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3030 CENTRE POINTE DR STE 700
Mailing Address - Street 2:
Mailing Address - City:ROSEVILLE
Mailing Address - State:MN
Mailing Address - Zip Code:55113-1112
Mailing Address - Country:US
Mailing Address - Phone:651-324-1949
Mailing Address - Fax:
Practice Address - Street 1:3030 CENTRE POINTE DR STE 700
Practice Address - Street 2:
Practice Address - City:ROSEVILLE
Practice Address - State:MN
Practice Address - Zip Code:55113-1112
Practice Address - Country:US
Practice Address - Phone:651-324-1949
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-09-12
Last Update Date:2025-09-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN121052183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist