Provider Demographics
NPI:1104175942
Name:SHERIDAN, JULIE ANNE (PHARMD)
Entity type:Individual
Prefix:DR
First Name:JULIE
Middle Name:ANNE
Last Name:SHERIDAN
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:15177 W.P. STEWART RD.
Mailing Address - Street 2:
Mailing Address - City:BOGALUSA
Mailing Address - State:LA
Mailing Address - Zip Code:70427
Mailing Address - Country:US
Mailing Address - Phone:985-516-2668
Mailing Address - Fax:985-732-5688
Practice Address - Street 1:133 CUMBERLAND ST
Practice Address - Street 2:
Practice Address - City:BOGALUSA
Practice Address - State:LA
Practice Address - Zip Code:70427-3101
Practice Address - Country:US
Practice Address - Phone:985-732-5874
Practice Address - Fax:985-732-5424
Is Sole Proprietor?:No
Enumeration Date:2012-09-07
Last Update Date:2020-10-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA019890183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist