Provider Demographics
NPI:1558180406
Name:SANCHEZ LOPEZ, JULYANNE IVELISSE (PHARMD)
Entity type:Individual
Prefix:
First Name:JULYANNE
Middle Name:IVELISSE
Last Name:SANCHEZ LOPEZ
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 1:11709 FOREST CREST LN
Mailing Address - Street 2:
Mailing Address - City:VANCLEAVE
Mailing Address - State:MS
Mailing Address - Zip Code:39565-7817
Mailing Address - Country:US
Mailing Address - Phone:228-623-9377
Mailing Address - Fax:
Practice Address - Street 1:2190 BIENVILLE BLVD
Practice Address - Street 2:
Practice Address - City:OCEAN SPRINGS
Practice Address - State:MS
Practice Address - Zip Code:39564-3017
Practice Address - Country:US
Practice Address - Phone:228-875-2881
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-10-08
Last Update Date:2024-10-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MSE-101735183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist