Provider Demographics
NPI:1154923241
Name:KUE, XOUA (PHARMD)
Entity type:Individual
Prefix:MR
First Name:XOUA
Middle Name:
Last Name:KUE
Suffix:
Gender:M
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3505 BOTTINEAU BLVD
Mailing Address - Street 2:
Mailing Address - City:ROBBINSDALE
Mailing Address - State:MN
Mailing Address - Zip Code:55422-6602
Mailing Address - Country:US
Mailing Address - Phone:612-287-7201
Mailing Address - Fax:612-287-7239
Practice Address - Street 1:3505 BOTTINEAU BLVD
Practice Address - Street 2:
Practice Address - City:ROBBINSDALE
Practice Address - State:MN
Practice Address - Zip Code:55422-6602
Practice Address - Country:US
Practice Address - Phone:612-287-7201
Practice Address - Fax:612-287-7239
Is Sole Proprietor?:No
Enumeration Date:2020-11-12
Last Update Date:2020-11-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN122124183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist