Provider Demographics
NPI:1740402189
Name:JUST, NOELL DEBRA (RPH)
Entity Type:Individual
Prefix:MRS
First Name:NOELL
Middle Name:DEBRA
Last Name:JUST
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 1:1020 BEAUMONT DRIVE
Mailing Address - Street 2:
Mailing Address - City:HAZEN
Mailing Address - State:ND
Mailing Address - Zip Code:58545
Mailing Address - Country:US
Mailing Address - Phone:701-748-6261
Mailing Address - Fax:
Practice Address - Street 1:30 WEST MAIN
Practice Address - Street 2:
Practice Address - City:HAZEN
Practice Address - State:ND
Practice Address - Zip Code:58545
Practice Address - Country:US
Practice Address - Phone:701-748-2636
Practice Address - Fax:701-748-2637
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-03
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ND3628183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist