Provider Demographics
NPI:1255472437
Name:FULLBRIGHT, SHEILA MARIE (RPH)
Entity Type:Individual
Prefix:MS
First Name:SHEILA
Middle Name:MARIE
Last Name:FULLBRIGHT
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 1:3245 HOSPITAL DR
Mailing Address - Street 2:
Mailing Address - City:JUNEAU
Mailing Address - State:AK
Mailing Address - Zip Code:99801-7809
Mailing Address - Country:US
Mailing Address - Phone:907-463-4031
Mailing Address - Fax:907-463-6658
Practice Address - Street 1:1200 SALMON CREEK LANE
Practice Address - Street 2:
Practice Address - City:JUNEAU
Practice Address - State:AK
Practice Address - Zip Code:99801
Practice Address - Country:US
Practice Address - Phone:907-463-4031
Practice Address - Fax:907-463-6658
Is Sole Proprietor?:No
Enumeration Date:2007-02-09
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC009281183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist