Provider Demographics
NPI:1700216785
Name:YONNES, BRENDA ANN (PHARMD)
Entity Type:Individual
Prefix:DR
First Name:BRENDA
Middle Name:ANN
Last Name:YONNES
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:
Other - First Name:BRENDA
Other - Middle Name:ANN
Other - Last Name:WOOLEVER
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:510 E STONER AVE
Mailing Address - Street 2:
Mailing Address - City:SHREVEPORT
Mailing Address - State:LA
Mailing Address - Zip Code:71101-4243
Mailing Address - Country:US
Mailing Address - Phone:318-221-8411
Mailing Address - Fax:
Practice Address - Street 1:510 E STONER AVE
Practice Address - Street 2:
Practice Address - City:SHREVEPORT
Practice Address - State:LA
Practice Address - Zip Code:71101-4243
Practice Address - Country:US
Practice Address - Phone:318-221-8411
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-11-12
Last Update Date:2023-09-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA0189591835I0206X
LAPST 018959183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes183500000XPharmacy Service ProvidersPharmacist
No1835I0206XPharmacy Service ProvidersPharmacistInfectious DiseasesGroup - Multi-Specialty