Provider Demographics
NPI:1487949590
Name:BARADAN, HEATHER KOSER (PHARMD, RPH)
Entity type:Individual
Prefix:DR
First Name:HEATHER
Middle Name:KOSER
Last Name:BARADAN
Suffix:
Gender:F
Credentials:PHARMD, RPH
Other - Prefix:DR
Other - First Name:HEATHER
Other - Middle Name:CHRISTINE
Other - Last Name:KOSER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PHARMD, RPH
Mailing Address - Street 1:1750 ROBERT ST S
Mailing Address - Street 2:
Mailing Address - City:WEST SAINT PAUL
Mailing Address - State:MN
Mailing Address - Zip Code:55118-3919
Mailing Address - Country:US
Mailing Address - Phone:651-455-6626
Mailing Address - Fax:651-455-1903
Practice Address - Street 1:1750 ROBERT ST S
Practice Address - Street 2:
Practice Address - City:WEST SAINT PAUL
Practice Address - State:MN
Practice Address - Zip Code:55118-3919
Practice Address - Country:US
Practice Address - Phone:651-455-6626
Practice Address - Fax:651-455-1903
Is Sole Proprietor?:Yes
Enumeration Date:2011-06-16
Last Update Date:2011-06-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN118271183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist