Individual
ANDREA BOULKA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CPHT
Contact information
Practice address
505 HOPE DR STE 14B, EAGAN, MN 55121-1003
(651) 324-0281
Mailing address
328 3RD AVE E, SHAKOPEE, MN 55379-1406
(651) 324-0281
Taxonomy
Speciality
Code
Description
License number
State
183700000X
Pharmacy Technician
Primary
738488
MN
Other
Enumeration date
05/22/2023
Last updated
05/22/2023
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