Provider Demographics
NPI:1215628961
Name:ASHBY, BRIANNA CATHERINE (PHARMD)
Entity type:Individual
Prefix:
First Name:BRIANNA
Middle Name:CATHERINE
Last Name:ASHBY
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:PO BOX 546
Mailing Address - Street 2:
Mailing Address - City:SALEM
Mailing Address - State:IL
Mailing Address - Zip Code:62881-0546
Mailing Address - Country:US
Mailing Address - Phone:618-548-4000
Mailing Address - Fax:618-548-3784
Practice Address - Street 1:1413 W WHITTAKER ST
Practice Address - Street 2:
Practice Address - City:SALEM
Practice Address - State:IL
Practice Address - Zip Code:62881-2015
Practice Address - Country:US
Practice Address - Phone:618-548-4000
Practice Address - Fax:618-548-3784
Is Sole Proprietor?:No
Enumeration Date:2023-05-15
Last Update Date:2023-05-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL051304307183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist