Provider Demographics
NPI:1306154869
Name:GIANNOBILE, KAREN S (RPH)
Entity type:Individual
Prefix:
First Name:KAREN
Middle Name:S
Last Name:GIANNOBILE
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 1:1806 AURORA ST
Mailing Address - Street 2:
Mailing Address - City:MONROE
Mailing Address - State:LA
Mailing Address - Zip Code:71201-2102
Mailing Address - Country:US
Mailing Address - Phone:318-387-5297
Mailing Address - Fax:
Practice Address - Street 1:2279 LOUISVILLE AVE
Practice Address - Street 2:
Practice Address - City:MONROE
Practice Address - State:LA
Practice Address - Zip Code:71201-6124
Practice Address - Country:US
Practice Address - Phone:318-325-6921
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-09-18
Last Update Date:2010-09-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA10716183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist