Provider Demographics
NPI:1336326636
Name:JOE, JANELLE E (PHARM D)
Entity Type:Individual
Prefix:MRS
First Name:JANELLE
Middle Name:E
Last Name:JOE
Suffix:
Gender:F
Credentials:PHARM D
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11312 HIGHWAY 49
Mailing Address - Street 2:
Mailing Address - City:GULFPORT
Mailing Address - State:MS
Mailing Address - Zip Code:39503-3086
Mailing Address - Country:US
Mailing Address - Phone:228-832-0051
Mailing Address - Fax:228-832-0168
Practice Address - Street 1:11312 HIGHWAY 49
Practice Address - Street 2:
Practice Address - City:GULFPORT
Practice Address - State:MS
Practice Address - Zip Code:39503-3086
Practice Address - Country:US
Practice Address - Phone:228-832-0051
Practice Address - Fax:228-832-0168
Is Sole Proprietor?:No
Enumeration Date:2008-01-29
Last Update Date:2008-01-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MSE-010236183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist