Healthcare Provider Details

I. General information

NPI: 1770447435
Provider Name (Legal Business Name): TREVER SHELDON
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/16/2025
Last Update Date: 12/16/2025
Certification Date: 12/16/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1265 GREY FOX RD STE 300
ARDEN HILLS MN
55112-6932
US

IV. Provider business mailing address

1265 GREY FOX RD STE 300
ARDEN HILLS MN
55112-6932
US

V. Phone/Fax

Practice location:
  • Phone: 612-238-8615
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License Number127215
License Number StateMN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: