Provider Demographics
NPI:1629382486
Name:KUNNU, ABISOLA (PHARMD)
Entity Type:Individual
Prefix:DR
First Name:ABISOLA
Middle Name:
Last Name:KUNNU
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 1:2019 N MAIN ST
Mailing Address - Street 2:
Mailing Address - City:HIGH POINT
Mailing Address - State:NC
Mailing Address - Zip Code:27262-2133
Mailing Address - Country:US
Mailing Address - Phone:336-885-7766
Mailing Address - Fax:336-885-7787
Practice Address - Street 1:2019 N MAIN ST
Practice Address - Street 2:
Practice Address - City:HIGH POINT
Practice Address - State:NC
Practice Address - Zip Code:27262-2133
Practice Address - Country:US
Practice Address - Phone:336-885-7766
Practice Address - Fax:336-885-7787
Is Sole Proprietor?:No
Enumeration Date:2010-08-03
Last Update Date:2010-08-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC18498183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist