Provider Demographics
NPI:1881280329
Name:VIHOVDE, CONSTANCE ANN
Entity type:Individual
Prefix:
First Name:CONSTANCE
Middle Name:ANN
Last Name:VIHOVDE
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:15625 ALPINE CIR
Mailing Address - Street 2:
Mailing Address - City:BURNSVILLE
Mailing Address - State:MN
Mailing Address - Zip Code:55306-5483
Mailing Address - Country:US
Mailing Address - Phone:952-649-8432
Mailing Address - Fax:
Practice Address - Street 1:7435 179TH ST W
Practice Address - Street 2:
Practice Address - City:LAKEVILLE
Practice Address - State:MN
Practice Address - Zip Code:55044-5264
Practice Address - Country:US
Practice Address - Phone:952-891-5050
Practice Address - Fax:952-891-5885
Is Sole Proprietor?:No
Enumeration Date:2020-12-18
Last Update Date:2020-12-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN114138183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist