Provider Demographics
NPI:1417713066
Name:AGRE, ANDREA FRANCES (PHARMD)
Entity Type:Individual
Prefix:
First Name:ANDREA
Middle Name:FRANCES
Last Name:AGRE
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 1:102 NORWAY CT
Mailing Address - Street 2:
Mailing Address - City:BRAINERD
Mailing Address - State:MN
Mailing Address - Zip Code:56401-4500
Mailing Address - Country:US
Mailing Address - Phone:218-296-1088
Mailing Address - Fax:
Practice Address - Street 1:13650 ELDER DR
Practice Address - Street 2:
Practice Address - City:BAXTER
Practice Address - State:MN
Practice Address - Zip Code:56425-8818
Practice Address - Country:US
Practice Address - Phone:218-855-5755
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-02-22
Last Update Date:2024-02-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN119296183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist