Provider Demographics
NPI:1811121296
Name:HALLMAN, MICHELLE B (PHARMACY TECHNICIAN)
Entity type:Individual
Prefix:
First Name:MICHELLE
Middle Name:B
Last Name:HALLMAN
Suffix:
Gender:F
Credentials:PHARMACY TECHNICIAN
Other - Prefix:
Other - First Name:MICHELLE
Other - Middle Name:B
Other - Last Name:MEINKE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:1010 4TH ST
Mailing Address - Street 2:
Mailing Address - City:TWO HARBORS
Mailing Address - State:MN
Mailing Address - Zip Code:55616-1200
Mailing Address - Country:US
Mailing Address - Phone:218-834-7202
Mailing Address - Fax:218-834-9531
Practice Address - Street 1:1010 4TH ST
Practice Address - Street 2:
Practice Address - City:TWO HARBORS
Practice Address - State:MN
Practice Address - Zip Code:55616-1200
Practice Address - Country:US
Practice Address - Phone:218-834-7202
Practice Address - Fax:218-834-9531
Is Sole Proprietor?:No
Enumeration Date:2009-05-13
Last Update Date:2009-12-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN718614183700000X
MN4901-0701-0035-294183700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183700000XPharmacy Service ProvidersPharmacy Technician