Active NPI
Amanda Manning Hultgren, PHARMD
- Pharmacist
- Bloomington, MN
National Provider Identifier
1669051603
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- 118143
- Practice address
- 700 American Blvd E
Bloomington, MN 55420-1336 - Phone
- (952) 854-8850
- NPI assigned
- Apr 6, 2021
- Last updated
- Apr 6, 2021
- Sex
- Female
- Sole proprietor
- Yes
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 | 118143 | MN | Primary |
Addresses
Primary practice location
700 American Blvd E
Bloomington, MN 55420-1336
Mailing address
4617 Sparrow Rd
Minnetonka, MN 55345-2444
Phone (952) 412-2334
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 |
|---|---|---|---|
| 118143 | MN | MD | Pharmacist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1617667200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1617667200000",
"number": "1669051603",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4617 SPARROW RD",
"city": "MINNETONKA",
"state": "MN",
"postal_code": "553452444",
"telephone_number": "952-412-2334"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "700 AMERICAN BLVD E",
"city": "BLOOMINGTON",
"state": "MN",
"postal_code": "554201336",
"telephone_number": "952-854-8850"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MANNING HULTGREN",
"first_name": "AMANDA",
"credential": "PHARMD",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2021-04-06",
"last_updated": "2021-04-06",
"certification_date": "2021-04-06",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "MN",
"license": "118143",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Bloomington, MN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 6, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.