Provider Demographics
NPI:1205481785
Name:WALSH, GAIL ANNE (PHARMD)
Entity type:Individual
Prefix:DR
First Name:GAIL
Middle Name:ANNE
Last Name:WALSH
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 1:4940 CORRALES RD STE 200
Mailing Address - Street 2:
Mailing Address - City:CORRALES
Mailing Address - State:NM
Mailing Address - Zip Code:87048-8673
Mailing Address - Country:US
Mailing Address - Phone:505-867-0733
Mailing Address - Fax:
Practice Address - Street 1:4940 CORRALES RD
Practice Address - Street 2:
Practice Address - City:CORRALES
Practice Address - State:NM
Practice Address - Zip Code:87048-8673
Practice Address - Country:US
Practice Address - Phone:505-897-3784
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-08-02
Last Update Date:2023-05-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NMRP00009012183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist