Provider Demographics
NPI:1295148005
Name:GNIP, EMILY (RPH)
Entity type:Individual
Prefix:
First Name:EMILY
Middle Name:
Last Name:GNIP
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 1:530 N KENWOOD ST
Mailing Address - Street 2:SUITE 308
Mailing Address - City:GLENDALE
Mailing Address - State:CA
Mailing Address - Zip Code:91206-3263
Mailing Address - Country:US
Mailing Address - Phone:928-763-6822
Mailing Address - Fax:928-763-6817
Practice Address - Street 1:530 N KENWOOD ST
Practice Address - Street 2:SUITE 308
Practice Address - City:GLENDALE
Practice Address - State:CA
Practice Address - Zip Code:91206-3263
Practice Address - Country:US
Practice Address - Phone:928-763-6822
Practice Address - Fax:928-763-6817
Is Sole Proprietor?:Yes
Enumeration Date:2014-06-09
Last Update Date:2014-06-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZS015243183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist