Provider Demographics
NPI:1023611365
Name:SZAMBELAN, JULIE (RPH)
Entity type:Individual
Prefix:
First Name:JULIE
Middle Name:
Last Name:SZAMBELAN
Suffix:
Gender:F
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3784 150TH ST W
Mailing Address - Street 2:
Mailing Address - City:ROSEMOUNT
Mailing Address - State:MN
Mailing Address - Zip Code:55068-4761
Mailing Address - Country:US
Mailing Address - Phone:651-423-0316
Mailing Address - Fax:651-423-0319
Practice Address - Street 1:3784 150TH ST W
Practice Address - Street 2:
Practice Address - City:ROSEMOUNT
Practice Address - State:MN
Practice Address - Zip Code:55068-4761
Practice Address - Country:US
Practice Address - Phone:651-423-0316
Practice Address - Fax:651-423-0319
Is Sole Proprietor?:Yes
Enumeration Date:2020-11-19
Last Update Date:2020-12-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN115315183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist