| Doctor Name: | BRENDA MARIE PEDERSON |
| NPI Number: | 1801118955 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | RPH |
| License Number: | 114314 |
| Business Practice Address: | 6616 Union Lake Trl Lonsdale, MN - 550464324 |
| Business Phone Number: | 5077442958 |
| Business Fax Number: | 5077445894 |
| Mailing Address: | 6616 Union Lake Trl, LONSDALE |
| State: | MN |
| Postal Code: | 550464324 |
| Phone Number: | 5077442958 |
| Fax Number: | 5077445894 |
| NPI Enumeration Date: | 02/17/2010 |
| NPI Last Update Date: | 02/17/2010 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 1835G0303X |
| License Number: | 114314 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | MN |
| Taxonomy Type: | Pharmacy Service Providers |
| Taxonomy Classification: | Pharmacist |
| Taxonomy Specialization: | Geriatric |
| Taxonomy Definition: | A pharmacist who is certified in geriatric pharmacy practice is designated as a |