Provider Demographics
NPI:1851386940
Name:GIEFER, SANDRA RAE (R PH)
Entity Type:Individual
Prefix:MRS
First Name:SANDRA
Middle Name:RAE
Last Name:GIEFER
Suffix:
Gender:F
Credentials:R PH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:19767 JERSEY AVE
Mailing Address - Street 2:
Mailing Address - City:LAKEVILLE
Mailing Address - State:MN
Mailing Address - Zip Code:55044-9435
Mailing Address - Country:US
Mailing Address - Phone:952-967-5812
Mailing Address - Fax:952-883-5875
Practice Address - Street 1:8100 34TH AVE S
Practice Address - Street 2:
Practice Address - City:BLOOMINGTON
Practice Address - State:MN
Practice Address - Zip Code:55425-1672
Practice Address - Country:US
Practice Address - Phone:952-967-5812
Practice Address - Fax:952-883-5875
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-09-14
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN113698-61835P1200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1835P1200XPharmacy Service ProvidersPharmacistPharmacotherapy