Provider Demographics
NPI:1801439633
Name:RICHESON, JODEE (PHARMD)
Entity type:Individual
Prefix:
First Name:JODEE
Middle Name:
Last Name:RICHESON
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 1:820 27TH ST NW
Mailing Address - Street 2:
Mailing Address - City:MINOT
Mailing Address - State:ND
Mailing Address - Zip Code:58703-1762
Mailing Address - Country:US
Mailing Address - Phone:701-720-3182
Mailing Address - Fax:
Practice Address - Street 1:1118 S BROADWAY
Practice Address - Street 2:
Practice Address - City:MINOT
Practice Address - State:ND
Practice Address - Zip Code:58701-5955
Practice Address - Country:US
Practice Address - Phone:701-441-7345
Practice Address - Fax:866-291-1415
Is Sole Proprietor?:No
Enumeration Date:2019-10-24
Last Update Date:2024-08-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NDRPH4978183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist