Provider Demographics
NPI:1326207580
Name:STAUB, GAIL MARIE (PHARMD)
Entity Type:Individual
Prefix:MS
First Name:GAIL
Middle Name:MARIE
Last Name:STAUB
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 1:7418 W TWIN OAKS CT
Mailing Address - Street 2:
Mailing Address - City:FRANKLIN
Mailing Address - State:WI
Mailing Address - Zip Code:53132-2704
Mailing Address - Country:US
Mailing Address - Phone:414-858-2488
Mailing Address - Fax:
Practice Address - Street 1:7418 TWIN OAKS COURT
Practice Address - Street 2:
Practice Address - City:FRANKLIN
Practice Address - State:WI
Practice Address - Zip Code:53132-2704
Practice Address - Country:US
Practice Address - Phone:414-858-2488
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-06-03
Last Update Date:2008-06-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI12136-040183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist