Provider Demographics
NPI:1578174728
Name:SIRIANNI, ANGELITA NELSON (RPH)
Entity Type:Individual
Prefix:DR
First Name:ANGELITA
Middle Name:NELSON
Last Name:SIRIANNI
Suffix:
Gender:F
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2380 CLAIRMONT DRIVE WEST
Mailing Address - Street 2:
Mailing Address - City:SEMMES
Mailing Address - State:AL
Mailing Address - Zip Code:36575
Mailing Address - Country:US
Mailing Address - Phone:251-786-5746
Mailing Address - Fax:
Practice Address - Street 1:601 E I65 SERVICE RD S
Practice Address - Street 2:
Practice Address - City:MOBILE
Practice Address - State:AL
Practice Address - Zip Code:36606-3901
Practice Address - Country:US
Practice Address - Phone:251-479-6048
Practice Address - Fax:251-479-6452
Is Sole Proprietor?:Yes
Enumeration Date:2020-08-12
Last Update Date:2020-08-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MSE-15624183500000X
AL21024183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist