Provider Demographics
NPI:1447559141
Name:PAMPARO, BRIANNE NOHELANI (PHARM,D)
Entity Type:Individual
Prefix:
First Name:BRIANNE
Middle Name:NOHELANI
Last Name:PAMPARO
Suffix:
Gender:F
Credentials:PHARM,D
Other - Prefix:
Other - First Name:BRIANNE
Other - Middle Name:NOHELANI
Other - Last Name:YEN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:30 RIDGEBRIAR LN
Mailing Address - Street 2:
Mailing Address - City:NEWNAN
Mailing Address - State:GA
Mailing Address - Zip Code:30265-6214
Mailing Address - Country:US
Mailing Address - Phone:360-286-7684
Mailing Address - Fax:
Practice Address - Street 1:211 TEMPLE AVE
Practice Address - Street 2:
Practice Address - City:NEWNAN
Practice Address - State:GA
Practice Address - Zip Code:30263-1328
Practice Address - Country:US
Practice Address - Phone:770-253-8562
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-03-21
Last Update Date:2011-03-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GARPH024472183500000X
WAPH60013989183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist