Individual
MRS. NICHOLE LEIGH STEPHANE
Active
Sole proprietor
Provider details
NPI number
Gender
F
Credential
R.PH.
Contact information
Practice address
711 KASOTA AVE SE, MINNEAPOLIS, MN 55414-2842
(612) 672-5585
(612) 672-5201
Mailing address
3133 DEAN CT, MINNEAPOLIS, MN 55416-4385
(612) 927-4728
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
116636-7
MN
Other
Enumeration date
07/05/2005
Last updated
07/08/2007
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