Active NPI
Andrea Lynn Anderson, PHARM.D.
- Pharmacist
- Albertville, MN
National Provider Identifier
1508054339
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- 118229
- Practice address
- 5698 Lacentre Ave NE
Albertville, MN 55301 - Phone
- (763) 497-1139
- Fax
- (763) 497-5241
- NPI assigned
- Oct 5, 2007
- Last updated
- Oct 5, 2007
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pharmacist | 183500000X | 118229 | MN | Primary |
Addresses
Primary practice location
5698 Lacentre Ave NE
Albertville, MN 55301
Mailing address
5698 Lacentre Ave NE
Albertville, MN 55301
Phone (763) 497-1139
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
- Credentials
- Doctor of Pharmacy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 118229 | MN | MD | Pharmacist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Coborns Inc | Past | Accepting new patients | |
| Fairview Express Care | Past | Accepting new patients |
Organizations & group practices 2
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
-
- General Practice Physician
- Edina, MN
- NPI 1831707207
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1191542400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1191542400000",
"number": "1508054339",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "5698 LACENTRE AVE NE",
"city": "ALBERTVILLE",
"state": "MN",
"postal_code": "55301",
"telephone_number": "763-497-1139",
"fax_number": "763-497-5241"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "5698 LACENTRE AVE NE",
"city": "ALBERTVILLE",
"state": "MN",
"postal_code": "55301",
"telephone_number": "763-497-1139",
"fax_number": "763-497-5241"
}
],
"practiceLocations": [],
"basic": {
"last_name": "ANDERSON",
"first_name": "ANDREA",
"middle_name": "LYNN",
"name_prefix": "Dr.",
"credential": "PHARM.D.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2007-10-05",
"last_updated": "2007-10-05",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "MN",
"license": "118229",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Albertville, MN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 5, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.