Provider Demographics
NPI:1326217571
Name:YOURELL, ANN L (RPH)
Entity Type:Individual
Prefix:MS
First Name:ANN
Middle Name:L
Last Name:YOURELL
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 1:2442 STATE RD
Mailing Address - Street 2:
Mailing Address - City:LA CROSSE
Mailing Address - State:WI
Mailing Address - Zip Code:54601-6155
Mailing Address - Country:US
Mailing Address - Phone:608-775-8590
Mailing Address - Fax:608-775-8598
Practice Address - Street 1:2442 STATE RD
Practice Address - Street 2:
Practice Address - City:LA CROSSE
Practice Address - State:WI
Practice Address - Zip Code:54601-6155
Practice Address - Country:US
Practice Address - Phone:608-775-8590
Practice Address - Fax:608-775-8598
Is Sole Proprietor?:No
Enumeration Date:2008-02-21
Last Update Date:2008-02-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI11917-04183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist
Provider Identifiers
StateIdentifier IDID TypeIssuer
WI11917-04OtherSTATE OF WISCONSIN