Individual
ASHLEY RAE NIEMCZYK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PHARMD
Contact information
Practice address
640 JACKSON ST, SAINT PAUL, MN 55101-2502
(651) 254-1551
Mailing address
640 JACKSON ST, SAINT PAUL, MN 55101-2502
(651) 254-1551
Taxonomy
Speciality
Code
Description
License number
State
1835P1200X
Pharmacotherapy Pharmacist
Primary
120973
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
120973
MINNESOTA PHARMACIST LICENSE
MN
Enumeration date
11/26/2012
Last updated
11/26/2012
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