Provider Demographics
NPI:1205178852
Name:BIEURANCE, DANIEL JEROME (RPH)
Entity Type:Individual
Prefix:MR
First Name:DANIEL
Middle Name:JEROME
Last Name:BIEURANCE
Suffix:
Gender:M
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:9796 VALE ST NW
Mailing Address - Street 2:
Mailing Address - City:COON RAPIDS
Mailing Address - State:MN
Mailing Address - Zip Code:55433-5546
Mailing Address - Country:US
Mailing Address - Phone:612-986-7827
Mailing Address - Fax:763-205-2074
Practice Address - Street 1:9243 E RIVER RD NW
Practice Address - Street 2:
Practice Address - City:COON RAPIDS
Practice Address - State:MN
Practice Address - Zip Code:55433-5722
Practice Address - Country:US
Practice Address - Phone:763-205-2074
Practice Address - Fax:763-205-1643
Is Sole Proprietor?:No
Enumeration Date:2013-03-21
Last Update Date:2013-03-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN116339183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist