Provider Demographics
NPI:1831710045
Name:PARENTEAU, ASHLEY MARIE (PHARMD)
Entity type:Individual
Prefix:DR
First Name:ASHLEY
Middle Name:MARIE
Last Name:PARENTEAU
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 1:24650 190TH ST NW
Mailing Address - Street 2:
Mailing Address - City:BIG LAKE
Mailing Address - State:MN
Mailing Address - Zip Code:55309-4909
Mailing Address - Country:US
Mailing Address - Phone:763-486-5807
Mailing Address - Fax:
Practice Address - Street 1:2420 W DIVISION ST
Practice Address - Street 2:
Practice Address - City:SAINT CLOUD
Practice Address - State:MN
Practice Address - Zip Code:56301-3926
Practice Address - Country:US
Practice Address - Phone:320-253-5366
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-04-28
Last Update Date:2020-04-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN120977183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist