Provider Demographics
NPI:1083605489
Name:OKERLUND, RYAN E (PHARMD)
Entity Type:Individual
Prefix:DR
First Name:RYAN
Middle Name:E
Last Name:OKERLUND
Suffix:
Gender:M
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:401 BELTRAMI AVE NW
Mailing Address - Street 2:
Mailing Address - City:BEMIDJI
Mailing Address - State:MN
Mailing Address - Zip Code:56601-3106
Mailing Address - Country:US
Mailing Address - Phone:218-444-3000
Mailing Address - Fax:218-444-6640
Practice Address - Street 1:401 BELTRAMI AVE NW
Practice Address - Street 2:
Practice Address - City:BEMIDJI
Practice Address - State:MN
Practice Address - Zip Code:56601-3106
Practice Address - Country:US
Practice Address - Phone:218-444-3000
Practice Address - Fax:218-444-6640
Is Sole Proprietor?:No
Enumeration Date:2005-11-03
Last Update Date:2022-07-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN1178643183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist