Provider Demographics
NPI:1871287318
Name:KNUDSON, ABIGAIL JEAN (PHARMD)
Entity type:Individual
Prefix:
First Name:ABIGAIL
Middle Name:JEAN
Last Name:KNUDSON
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 1:15336 452ND AVE
Mailing Address - Street 2:
Mailing Address - City:SUMMIT
Mailing Address - State:SD
Mailing Address - Zip Code:57266-5101
Mailing Address - Country:US
Mailing Address - Phone:605-520-0369
Mailing Address - Fax:
Practice Address - Street 1:1320 9TH AVE SE
Practice Address - Street 2:
Practice Address - City:WATERTOWN
Practice Address - State:SD
Practice Address - Zip Code:57201-5302
Practice Address - Country:US
Practice Address - Phone:605-886-0661
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-06-07
Last Update Date:2023-06-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SD7033183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist