Provider Demographics
NPI:1528344595
Name:ESPANDER, CYNTHIA ANNE (PHARMACIST)
Entity type:Individual
Prefix:
First Name:CYNTHIA
Middle Name:ANNE
Last Name:ESPANDER
Suffix:
Gender:F
Credentials:PHARMACIST
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2200 HIGHWAY 13 E
Mailing Address - Street 2:
Mailing Address - City:BURNSVILLE
Mailing Address - State:MN
Mailing Address - Zip Code:55337-3030
Mailing Address - Country:US
Mailing Address - Phone:952-882-7998
Mailing Address - Fax:952-882-6561
Practice Address - Street 1:2200 HIGHWAY 13 E
Practice Address - Street 2:
Practice Address - City:BURNSVILLE
Practice Address - State:MN
Practice Address - Zip Code:55337-3030
Practice Address - Country:US
Practice Address - Phone:952-882-7998
Practice Address - Fax:952-882-6561
Is Sole Proprietor?:No
Enumeration Date:2011-10-22
Last Update Date:2011-10-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN111207183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist
Provider Identifiers
StateIdentifier IDID TypeIssuer
MN111207OtherPHARMACIST