Provider Demographics
NPI:1801911250
Name:BRINDLEY, JANISE BOGENSCHUTZ (RPH)
Entity type:Individual
Prefix:MS
First Name:JANISE
Middle Name:BOGENSCHUTZ
Last Name:BRINDLEY
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 1:16762 563 AVE
Mailing Address - Street 2:
Mailing Address - City:GOOD THUNDER
Mailing Address - State:MN
Mailing Address - Zip Code:56037
Mailing Address - Country:US
Mailing Address - Phone:507-278-3142
Mailing Address - Fax:
Practice Address - Street 1:36 SO BROADWAY
Practice Address - Street 2:
Practice Address - City:WELLS
Practice Address - State:MN
Practice Address - Zip Code:56097-0036
Practice Address - Country:US
Practice Address - Phone:507-553-3161
Practice Address - Fax:507-553-3914
Is Sole Proprietor?:No
Enumeration Date:2007-03-21
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN1117633183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist