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General NPI Number Information
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NPI Number | 1184050775
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Entity Type | Individual
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Provider Name | HOLLY SMITH GIPSON PHARM.D.
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Gender | Female
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Dates
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Enumeration Date | 09/16/2013
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Last Update Date | 09/16/2013
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Provider Practice Location Address
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Address Line | 4851 WHITESBURG DR SE STE B
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City | HUNTSVILLE
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State | AL
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Zip | 35802-1626
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Country | US
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Telephone | 256-650-2396
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Fax |
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Provider Business Mailing Address
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Address Line | 2075 LAKEFRONT DR APT 1802
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City | HUNTSVILLE
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State | AL
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Zip | 35824-1421
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Country | US
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Telephone | 256-655-0950
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 183500000X
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Taxonomy Name | Pharmacist
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License Number | 17489
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License Number State | AL
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