Provider Demographics
NPI:1467749168
Name:RIORDEN, GABRIELLE (PHARMD)
Entity Type:Individual
Prefix:
First Name:GABRIELLE
Middle Name:
Last Name:RIORDEN
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 1:900 E SIX FORKS RD
Mailing Address - Street 2:APT 325
Mailing Address - City:RALEIGH
Mailing Address - State:NC
Mailing Address - Zip Code:27604-1818
Mailing Address - Country:US
Mailing Address - Phone:910-592-8039
Mailing Address - Fax:
Practice Address - Street 1:408 BEAMAN ST
Practice Address - Street 2:
Practice Address - City:CLINTON
Practice Address - State:NC
Practice Address - Zip Code:28328-2910
Practice Address - Country:US
Practice Address - Phone:910-592-8039
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-06-30
Last Update Date:2013-03-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC21926183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist