Provider Demographics
NPI:1740577303
Name:REDMOND, STEPHANIE AMBER (PHARMD, CDE)
Entity Type:Individual
Prefix:DR
First Name:STEPHANIE
Middle Name:AMBER
Last Name:REDMOND
Suffix:
Gender:F
Credentials:PHARMD, CDE
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2010 SHORELINE DR
Mailing Address - Street 2:
Mailing Address - City:WAYZATA
Mailing Address - State:MN
Mailing Address - Zip Code:55391-9140
Mailing Address - Country:US
Mailing Address - Phone:952-807-3502
Mailing Address - Fax:
Practice Address - Street 1:111 HUNDERTMARK RD STE 115N
Practice Address - Street 2:
Practice Address - City:CHASKA
Practice Address - State:MN
Practice Address - Zip Code:55318-1584
Practice Address - Country:US
Practice Address - Phone:952-361-2450
Practice Address - Fax:952-361-2461
Is Sole Proprietor?:No
Enumeration Date:2011-07-05
Last Update Date:2018-03-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN120382183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist