Provider Demographics
NPI:1144587122
Name:RANGEN, KATHERINE E (PHARM D)
Entity Type:Individual
Prefix:
First Name:KATHERINE
Middle Name:E
Last Name:RANGEN
Suffix:
Gender:F
Credentials:PHARM D
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:108 S 6TH ST
Mailing Address - Street 2:SUITE 1
Mailing Address - City:BRAINERD
Mailing Address - State:MN
Mailing Address - Zip Code:56401-3575
Mailing Address - Country:US
Mailing Address - Phone:218-829-0347
Mailing Address - Fax:218-829-4701
Practice Address - Street 1:108 S 6TH ST
Practice Address - Street 2:SUITE 1
Practice Address - City:BRAINERD
Practice Address - State:MN
Practice Address - Zip Code:56401-3575
Practice Address - Country:US
Practice Address - Phone:218-829-0347
Practice Address - Fax:218-829-4701
Is Sole Proprietor?:Yes
Enumeration Date:2012-04-16
Last Update Date:2012-04-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN119701183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist