Provider Demographics
NPI:1508072612
Name:DONNELLY, GIANNA B (PHARMD)
Entity Type:Individual
Prefix:
First Name:GIANNA
Middle Name:B
Last Name:DONNELLY
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 1:7664 N JOANNA DR
Mailing Address - Street 2:
Mailing Address - City:COEUR D ALENE
Mailing Address - State:ID
Mailing Address - Zip Code:83815-9850
Mailing Address - Country:US
Mailing Address - Phone:208-819-4125
Mailing Address - Fax:
Practice Address - Street 1:2003 LINCOLN WAY
Practice Address - Street 2:
Practice Address - City:COEUR D ALENE
Practice Address - State:ID
Practice Address - Zip Code:83814-2611
Practice Address - Country:US
Practice Address - Phone:208-666-3032
Practice Address - Fax:208-666-2990
Is Sole Proprietor?:No
Enumeration Date:2007-05-15
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IDP60031835P1200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1835P1200XPharmacy Service ProvidersPharmacistPharmacotherapy