Provider Demographics
NPI:1215213996
Name:STROMME, INGRID C
Entity Type:Individual
Prefix:
First Name:INGRID
Middle Name:C
Last Name:STROMME
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9124 BRODERICK BLVD
Mailing Address - Street 2:
Mailing Address - City:INVER GROVE HEIGHTS
Mailing Address - State:MN
Mailing Address - Zip Code:55076-5187
Mailing Address - Country:US
Mailing Address - Phone:651-251-3836
Mailing Address - Fax:651-251-3841
Practice Address - Street 1:9124 BRODERICK BLVD
Practice Address - Street 2:
Practice Address - City:INVER GROVE HEIGHTS
Practice Address - State:MN
Practice Address - Zip Code:55076-5187
Practice Address - Country:US
Practice Address - Phone:651-251-3836
Practice Address - Fax:651-251-3841
Is Sole Proprietor?:No
Enumeration Date:2011-10-26
Last Update Date:2011-10-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN115280183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist