Provider Demographics
NPI:1457635237
Name:GRAGNANI, VANESSA (PHARMD, RPH)
Entity Type:Individual
Prefix:DR
First Name:VANESSA
Middle Name:
Last Name:GRAGNANI
Suffix:
Gender:F
Credentials:PHARMD, RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 1783
Mailing Address - Street 2:
Mailing Address - City:CLOVIS
Mailing Address - State:CA
Mailing Address - Zip Code:93613-1783
Mailing Address - Country:US
Mailing Address - Phone:559-978-1232
Mailing Address - Fax:
Practice Address - Street 1:988 SIERRA ST
Practice Address - Street 2:
Practice Address - City:KINGSBURG
Practice Address - State:CA
Practice Address - Zip Code:93631-1554
Practice Address - Country:US
Practice Address - Phone:559-897-9733
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-09-28
Last Update Date:2011-09-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA61783183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist