Provider Demographics
NPI:1891072385
Name:RINDAHL, KATIE MARIE (PHARMD)
Entity Type:Individual
Prefix:
First Name:KATIE
Middle Name:MARIE
Last Name:RINDAHL
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 1:4548 GARFIELD AVE
Mailing Address - Street 2:APT 1
Mailing Address - City:MINNEAPOLIS
Mailing Address - State:MN
Mailing Address - Zip Code:55419-4849
Mailing Address - Country:US
Mailing Address - Phone:612-987-0242
Mailing Address - Fax:
Practice Address - Street 1:4548 GARFIELD AVE
Practice Address - Street 2:APT 1
Practice Address - City:MINNEAPOLIS
Practice Address - State:MN
Practice Address - Zip Code:55419-4849
Practice Address - Country:US
Practice Address - Phone:612-987-0242
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-11-10
Last Update Date:2011-11-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN120464183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist