Provider Demographics
NPI:1366067936
Name:CUNEO, ANDREA MARIE (PHARMD)
Entity type:Individual
Prefix:
First Name:ANDREA
Middle Name:MARIE
Last Name:CUNEO
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8109 PENNSYLVANIA RD
Mailing Address - Street 2:
Mailing Address - City:BLOOMINGTON
Mailing Address - State:MN
Mailing Address - Zip Code:55438-1136
Mailing Address - Country:US
Mailing Address - Phone:952-807-5938
Mailing Address - Fax:
Practice Address - Street 1:1291 TASHA DR
Practice Address - Street 2:
Practice Address - City:SHAKOPEE
Practice Address - State:MN
Practice Address - Zip Code:55379-4425
Practice Address - Country:US
Practice Address - Phone:952-233-3611
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-06-10
Last Update Date:2020-06-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN121383333600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes333600000XSuppliersPharmacy