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NPI Code Detail

MEDICARE: DR. STEPHANIE AMBER REDMOND PHARM.D., CDE

MEDICARE: DR. STEPHANIE AMBER REDMOND PHARM.D., CDE
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1183500000XPharmacist120382MN

General Provider Information

NPI Number : 1740577303
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. STEPHANIE AMBER REDMOND PHARM.D., CDE
Provider Business Mailing Address
First Line : 2010 SHORELINE DR
Second Line :
City : WAYZATA
State : MN
Zip : 55391-9140
Country : US
Telephone Number : 952-807-3502
Fax Number :
Provider Business Practice Location Address
First Line : 111 HUNDERTMARK RD STE 115N
Second Line :
City : CHASKA
State : MN
Zip : 55318-1584
Country : US
Telephone Number : 952-361-2450
Fax Number : 952-361-2461
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/05/2011
Last Update Date : 03/22/2018

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