Provider Demographics
NPI:1134854920
Name:NEIN, ANNA CLAIRE MCCUSKER (PHARMD)
Entity type:Individual
Prefix:
First Name:ANNA
Middle Name:CLAIRE MCCUSKER
Last Name:NEIN
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 1:321 HIGHWAY 10 W
Mailing Address - Street 2:
Mailing Address - City:DETROIT LAKES
Mailing Address - State:MN
Mailing Address - Zip Code:56501-3046
Mailing Address - Country:US
Mailing Address - Phone:218-847-9248
Mailing Address - Fax:218-847-8874
Practice Address - Street 1:211 MARKET DR STE C
Practice Address - Street 2:
Practice Address - City:PERHAM
Practice Address - State:MN
Practice Address - Zip Code:56573-2125
Practice Address - Country:US
Practice Address - Phone:218-346-4840
Practice Address - Fax:877-795-9596
Is Sole Proprietor?:No
Enumeration Date:2022-07-18
Last Update Date:2024-12-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN125682183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist