Provider Demographics
NPI:1851987952
Name:ROSSMAN, KIMBERLY J (PHARM D)
Entity Type:Individual
Prefix:
First Name:KIMBERLY
Middle Name:J
Last Name:ROSSMAN
Suffix:
Gender:F
Credentials:PHARM D
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:15350 CEDAR AVE
Mailing Address - Street 2:
Mailing Address - City:APPLE VALLEY
Mailing Address - State:MN
Mailing Address - Zip Code:55124-7021
Mailing Address - Country:US
Mailing Address - Phone:952-431-2221
Mailing Address - Fax:952-432-7283
Practice Address - Street 1:15350 CEDAR AVE
Practice Address - Street 2:
Practice Address - City:APPLE VALLEY
Practice Address - State:MN
Practice Address - Zip Code:55124-7021
Practice Address - Country:US
Practice Address - Phone:952-431-2221
Practice Address - Fax:952-432-7283
Is Sole Proprietor?:Yes
Enumeration Date:2020-12-14
Last Update Date:2020-12-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN117948183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist