Provider Demographics
NPI:1730473091
Name:OLMSCHENK, DANIELLE C (PHARMD)
Entity Type:Individual
Prefix:DR
First Name:DANIELLE
Middle Name:C
Last Name:OLMSCHENK
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:DR
Other - First Name:DANIELLE
Other - Middle Name:C
Other - Last Name:PETERSON
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PHARMD
Mailing Address - Street 1:1500 109TH AVE NE
Mailing Address - Street 2:T-1832
Mailing Address - City:BLAINE
Mailing Address - State:MN
Mailing Address - Zip Code:55449-4670
Mailing Address - Country:US
Mailing Address - Phone:763-354-1001
Mailing Address - Fax:763-354-1001
Practice Address - Street 1:1500 109TH AVE NE
Practice Address - Street 2:T-1832
Practice Address - City:BLAINE
Practice Address - State:MN
Practice Address - Zip Code:55449-4670
Practice Address - Country:US
Practice Address - Phone:763-354-1001
Practice Address - Fax:763-354-1001
Is Sole Proprietor?:No
Enumeration Date:2011-06-04
Last Update Date:2011-06-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN119854183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist