Healthcare Provider Details

I. General information

NPI: 1255222048
Provider Name (Legal Business Name): ASHLEY MAE NICHOLE HEROLD PHARMD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/10/2025
Last Update Date: 07/10/2025
Certification Date: 07/10/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

707 LUNDORFF DR # 2
SANDSTONE MN
55072-5099
US

IV. Provider business mailing address

501 EISENHOWER ST APT 218
SANDSTONE MN
55072-4713
US

V. Phone/Fax

Practice location:
  • Phone: 320-245-5500
  • Fax: 320-245-5123
Mailing address:
  • Phone: 320-232-5053
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License Number126935
License Number StateMN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: