Provider Demographics
NPI:1275036352
Name:JOSEPH, COURTNEY DIONNE-MARIE (PHARMD)
Entity Type:Individual
Prefix:
First Name:COURTNEY
Middle Name:DIONNE-MARIE
Last Name:JOSEPH
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 1:6412 WASHINGTON AVE
Mailing Address - Street 2:
Mailing Address - City:OCEAN SPRINGS
Mailing Address - State:MS
Mailing Address - Zip Code:39564-2335
Mailing Address - Country:US
Mailing Address - Phone:228-334-3053
Mailing Address - Fax:
Practice Address - Street 1:6412 WASHINGTON AVE
Practice Address - Street 2:
Practice Address - City:OCEAN SPRINGS
Practice Address - State:MS
Practice Address - Zip Code:39564-2335
Practice Address - Country:US
Practice Address - Phone:228-334-3053
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-03-14
Last Update Date:2018-03-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MSE-14534183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist