Provider Demographics
NPI:1801178348
Name:MAGNUSON, HELEN M (PHARMD)
Entity type:Individual
Prefix:DR
First Name:HELEN
Middle Name:M
Last Name:MAGNUSON
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:356 12TH ST SW
Mailing Address - Street 2:T1244
Mailing Address - City:FOREST LAKE
Mailing Address - State:MN
Mailing Address - Zip Code:55025-1749
Mailing Address - Country:US
Mailing Address - Phone:651-464-1994
Mailing Address - Fax:
Practice Address - Street 1:356 12TH ST SW
Practice Address - Street 2:T1244
Practice Address - City:FOREST LAKE
Practice Address - State:MN
Practice Address - Zip Code:55025-1749
Practice Address - Country:US
Practice Address - Phone:651-464-1994
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-09-11
Last Update Date:2011-09-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN116357183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist