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General NPI Number Information
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NPI Number | 1306995121
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Entity Type | Individual
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Provider Name | SHARYN SPELL GIETZEN R. PH.
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Gender | Female
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Dates
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Enumeration Date | 01/10/2007
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 803 FRIENDLY CENTER RD STE C
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City | GREENSBORO
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State | NC
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Zip | 27408-2024
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Country | US
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Telephone | 336-292-6888
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Fax |
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Provider Business Mailing Address
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Address Line | 2304 BAYRON CT
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City | COLFAX
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State | NC
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Zip | 27235-9652
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Country | US
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Telephone | 336-992-3994
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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 | 12269
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License Number State | NC
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