Provider Demographics
NPI:1295021772
Name:SLETTEN, JANNA LYNN (RPH)
Entity Type:Individual
Prefix:
First Name:JANNA
Middle Name:LYNN
Last Name:SLETTEN
Suffix:
Gender:F
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4848 COUNTY ROAD 101
Mailing Address - Street 2:T-1356
Mailing Address - City:MINNETONKA
Mailing Address - State:MN
Mailing Address - Zip Code:55345-2635
Mailing Address - Country:US
Mailing Address - Phone:952-401-3814
Mailing Address - Fax:
Practice Address - Street 1:4848 COUNTY ROAD 101
Practice Address - Street 2:T-1356
Practice Address - City:MINNETONKA
Practice Address - State:MN
Practice Address - Zip Code:55345-2635
Practice Address - Country:US
Practice Address - Phone:952-401-3814
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-06-23
Last Update Date:2011-06-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN114440183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist