Provider Demographics
NPI:1982200739
Name:CIPALA, BOBBI JOANN (PHARMACIST)
Entity Type:Individual
Prefix:
First Name:BOBBI
Middle Name:JOANN
Last Name:CIPALA
Suffix:
Gender:F
Credentials:PHARMACIST
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8432 TAMARACK VLG
Mailing Address - Street 2:
Mailing Address - City:WOODBURY
Mailing Address - State:MN
Mailing Address - Zip Code:55125-3383
Mailing Address - Country:US
Mailing Address - Phone:651-702-1034
Mailing Address - Fax:651-702-1035
Practice Address - Street 1:8432 TAMARACK VLG
Practice Address - Street 2:
Practice Address - City:WOODBURY
Practice Address - State:MN
Practice Address - Zip Code:55125-3383
Practice Address - Country:US
Practice Address - Phone:651-702-1034
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-12-08
Last Update Date:2020-12-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN115621183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist