Provider Demographics
NPI:1710252325
Name:THOMPSON, ANNE MARIE (PHARMD)
Entity Type:Individual
Prefix:DR
First Name:ANNE
Middle Name:MARIE
Last Name:THOMPSON
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 1:2108 E 123RD ST
Mailing Address - Street 2:
Mailing Address - City:BURNSVILLE
Mailing Address - State:MN
Mailing Address - Zip Code:55337-3108
Mailing Address - Country:US
Mailing Address - Phone:319-400-1020
Mailing Address - Fax:
Practice Address - Street 1:2108 E 123RD ST
Practice Address - Street 2:
Practice Address - City:BURNSVILLE
Practice Address - State:MN
Practice Address - Zip Code:55337-3108
Practice Address - Country:US
Practice Address - Phone:319-400-1020
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-03-14
Last Update Date:2012-03-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN119309183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist