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General NPI Number Information
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NPI Number | 1740591379
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Entity Type | Individual
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Provider Name | JOANN ISHAK YOUSSEF PHARM.D.
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Gender | Female
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Dates
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Enumeration Date | 06/29/2010
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Last Update Date | 06/29/2010
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Provider Practice Location Address
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Address Line | 214 BROAD ST
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City | ELIZABETHTON
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State | TN
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Zip | 37643-2714
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Country | US
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Telephone | 423-547-2733
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Fax |
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Provider Business Mailing Address
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Address Line | 109 RIDGEVIEW MEADOWS DR
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City | JOHNSON CITY
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State | TN
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Zip | 37615-5202
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Country | US
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Telephone | 630-569-2424
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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 | 33994
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License Number State | TN
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Taxonomy #2
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Taxonomy Code | 183500000X
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Taxonomy Name | Pharmacist
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License Number | 051292991
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License Number State | IL
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