DR. ANDREA BISTODEAU (NPI# 1760007918) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1760007918 |
| Entity Type | Individual |
| Full Name | DR. ANDREA BISTODEAU |
| Credential | PHARMD |
| Practice Address |
4369 Ball Road Ne Blaine MN 55014 |
| Practice Telephone | 7637840862 |
| Mailing Telephone | 7637840862 |
| Enumeration Date | 2020-06-13 |
| Last Update Date | 2020-06-13 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 183500000X | Pharmacist | 116919 | MN | Pharmacy Service Providers |
| Street Address |
4369 BALL ROAD NE |
| City | BLAINE |
| State | MN |
| Zip Code | 55014 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1417556853 | Dai Hoang | Pharmacist | 4369 Ball Road Ne, Blaine, MN 55014 | 2020-10-17 |
| 1669070652 | Nickolas William Scott | Pharmacist | 4369 Ball Road Ne, Blaine, MN 55014 | 2020-10-13 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1720462617 | Lino Lakes Gw, LLC | Assisted Living Facility | 675 Market Place Drive, Lino Lakes, MN 55014 | 2015-07-10 |
| 1578973376 | Beth Ann Schumacher | Counselor | 49 Central St Ste 2, Circle Pines, MN 55014 | 2014-05-01 |
| 1326479080 | Susan Grissom | Speech-Language Pathologist | 6776 Lake Drive, Advance Therapy, Lino Lakes, MN 55014 | 2013-12-06 |
| 1154759173 | Jennifer Cunningham | Massage Therapist | 3865 97th Ln Ne, Blaine, MN 55014 | 2013-10-30 |
| 1760695316 | Carol Elaine Jillian-ohana | Chiropractor | 7094 Lake Drive, Circle of Healing Arts, Lino Lakes, MN 55014 | 2007-05-08 |
| 1750434064 | Pamela Lynn Lenz | Speech-Language Pathologist | 6776 Lake Dr., #220, Lino Lakes, MN 55014 | 2007-01-19 |
| 1447342118 | David Joseph Beyer | Counselor | 7578 Leonard Ave., Lino Lakes, MN 55014 | 2006-09-29 |
| 1710089156 | Joel David Buys | Chiropractor | 7661 Lake Dr, Lino Lakes, MN 55014 | 2006-09-05 |
| 1881655538 | John M Stentz | Dentist | 640 Civic Heights Dr, Circle Pines, MN 55014 | 2006-03-31 |
| 1023563236 | Jasmin Carlblom | Physical Therapist | 6776 Lake Dr, Suite 220, Lino Lakes, MN 55014 | 2016-08-17 |
| Find all providers in zip 55014 | ||||
| Taxonomy Code | 183500000X |
| Grouping | Pharmacy Service Providers |
| Classification | Pharmacist |
| An individual licensed by the appropriate state regulatory agency to engage in the practice of pharmacy. The practice of pharmacy includes, but is not limited to, assessment, interpretation, evaluation, and implementation, initiation, monitoring or modification of medication and or medical orders; the compounding or dispensing of medication and or medical orders; participation in drug and device procurement, storage, and selection; drug administration; drug regimen reviews; drug or drug-related research; provision of patient education and the provision of those acts or services necessary to provide medication therapy management services in all areas of patient care. |
| Notes: Source: Adapted from National Association of Boards of Pharmacy Model State Pharmacy Act, Article 1, Section 104. [1/1/2006: definition modified, source modified] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1871008631 | Batool Dawood | Pharmacist | 627 129th Ln Ne, Blaine, MN 55434-3212 | 2017-12-02 |
| 1669927315 | Sonja Gunilla Norden | Pharmacist | 1195 Boblett St, Blaine, WA 98230-4062 | 2016-08-23 |
| 1942655311 | Raphael An Hoang | Pharmacist | 12303 Jefferson St Ne, Blaine, MN 55434-2000 | 2016-05-04 |
| 1093108250 | Julie Keese | Pharmacist | 180 Rutledge Pike, Blaine, TN 37709-2416 | 2015-03-12 |
| 1962822429 | Mowlid Balayah | Pharmacist | 12727 Leyte St Ne, Blaine, MN 55449-6792 | 2014-04-23 |
| 1578991790 | Shannon Kelly | Pharmacist | 2792 Lea Lake Rd, Blaine, TN 37709-5214 | 2013-10-25 |
| 1104101187 | Tyler G Dahlgren | Pharmacist | 2334 119th Ave Ne, Blaine, MN 55449-5412 | 2011-10-20 |
| 1386935898 | Benjamin Li | Pharmacist | 1733 H St, 500, Blaine, WA 98230-5156 | 2011-05-02 |
| 1356461271 | Sharon Kay Thoma | Pharmacist | 8949 University Ave Ne, Kmart Pharmacy, Blaine, MN 55434-8000 | 2007-04-02 |
| 1093316788 | Sia Yang | Pharmacist | 600 County Road 10 Ne, Blaine, MN 55434-2329 | 2020-11-08 |
| Find all providers in BLAINE | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.