Provider Demographics
NPI:1053457507
Name:HOLBROOK, MICHELLE LYNN (RPH, PHARMD, MSP)
Entity Type:Individual
Prefix:MRS
First Name:MICHELLE
Middle Name:LYNN
Last Name:HOLBROOK
Suffix:
Gender:F
Credentials:RPH, PHARMD, MSP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2311 MARBURY RD
Mailing Address - Street 2:
Mailing Address - City:PITTSBURGH
Mailing Address - State:PA
Mailing Address - Zip Code:15221-3669
Mailing Address - Country:US
Mailing Address - Phone:412-798-4429
Mailing Address - Fax:
Practice Address - Street 1:2311 MARBURY RD
Practice Address - Street 2:
Practice Address - City:PITTSBURGH
Practice Address - State:PA
Practice Address - Zip Code:15221
Practice Address - Country:US
Practice Address - Phone:412-784-4427
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-30
Last Update Date:2018-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PARP037327-L333600000X
PARP037327L183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist
No333600000XSuppliersPharmacy