Provider Demographics
NPI:1891078713
Name:FOGLEMAN, JULIANNA KATHLEEN (PHARMD)
Entity Type:Individual
Prefix:DR
First Name:JULIANNA
Middle Name:KATHLEEN
Last Name:FOGLEMAN
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 1:1420 W STONE DR
Mailing Address - Street 2:
Mailing Address - City:KINGSPORT
Mailing Address - State:TN
Mailing Address - Zip Code:37660-2522
Mailing Address - Country:US
Mailing Address - Phone:423-246-3551
Mailing Address - Fax:423-246-3939
Practice Address - Street 1:1420 W STONE DR
Practice Address - Street 2:
Practice Address - City:KINGSPORT
Practice Address - State:TN
Practice Address - Zip Code:37660-2522
Practice Address - Country:US
Practice Address - Phone:423-246-3551
Practice Address - Fax:423-246-3939
Is Sole Proprietor?:No
Enumeration Date:2011-09-27
Last Update Date:2011-09-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN36077183500000X
VA0202210848183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist