Healthcare Provider Details

I. General information

NPI: 1699972851
Provider Name (Legal Business Name): CHRISTINA LOUISE CIPOLLE PHARMD
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/29/2007
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

775 SCHOOL RD NW APT 204
HUTCHINSON MN
55350-1470
US

IV. Provider business mailing address

775 SCHOOL RD NW APT 204
HUTCHINSON MN
55350-1470
US

V. Phone/Fax

Practice location:
  • Phone: 507-647-5351
  • Fax:
Mailing address:
  • Phone: 320-455-0215
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License Number118855
License Number StateMN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: