Provider Demographics
NPI:1477822419
Name:HAUGERUD, SIGRUN (PHARMD)
Entity Type:Individual
Prefix:
First Name:SIGRUN
Middle Name:
Last Name:HAUGERUD
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 1:3207 E LAKE ST
Mailing Address - Street 2:
Mailing Address - City:MINNEAPOLIS
Mailing Address - State:MN
Mailing Address - Zip Code:55406-2029
Mailing Address - Country:US
Mailing Address - Phone:612-721-4868
Mailing Address - Fax:612-721-1261
Practice Address - Street 1:3207 E LAKE ST
Practice Address - Street 2:
Practice Address - City:MINNEAPOLIS
Practice Address - State:MN
Practice Address - Zip Code:55406-2029
Practice Address - Country:US
Practice Address - Phone:612-721-4868
Practice Address - Fax:612-721-1261
Is Sole Proprietor?:No
Enumeration Date:2011-12-20
Last Update Date:2011-12-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN119035183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist