Provider Demographics
NPI:1457646630
Name:FORRESTER, MICHELLE ANN (PHARMD)
Entity Type:Individual
Prefix:
First Name:MICHELLE
Middle Name:ANN
Last Name:FORRESTER
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 1:3489 LOWERY PKWY
Mailing Address - Street 2:T-2355
Mailing Address - City:FULTONDALE
Mailing Address - State:AL
Mailing Address - Zip Code:35068-1677
Mailing Address - Country:US
Mailing Address - Phone:205-453-6033
Mailing Address - Fax:205-453-6033
Practice Address - Street 1:3489 LOWERY PKWY
Practice Address - Street 2:T-2355
Practice Address - City:FULTONDALE
Practice Address - State:AL
Practice Address - Zip Code:35068-1677
Practice Address - Country:US
Practice Address - Phone:205-453-6033
Practice Address - Fax:205-453-6033
Is Sole Proprietor?:Yes
Enumeration Date:2011-06-15
Last Update Date:2011-06-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL16075183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist