Provider Demographics
NPI:1053860247
Name:KIRK, SHAWONA MONEE WALKER (PHARMD)
Entity Type:Individual
Prefix:
First Name:SHAWONA
Middle Name:MONEE WALKER
Last Name:KIRK
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:
Other - First Name:SHAWONA
Other - Middle Name:MONEE
Other - Last Name:WALKER-KIRK
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:PHARMD
Mailing Address - Street 1:2425 N SLAPPEY BLVD
Mailing Address - Street 2:
Mailing Address - City:ALBANY
Mailing Address - State:GA
Mailing Address - Zip Code:31701-1009
Mailing Address - Country:US
Mailing Address - Phone:229-883-5047
Mailing Address - Fax:229-883-6498
Practice Address - Street 1:2425 N SLAPPEY BLVD
Practice Address - Street 2:
Practice Address - City:ALBANY
Practice Address - State:GA
Practice Address - Zip Code:31701-1009
Practice Address - Country:US
Practice Address - Phone:229-883-5047
Practice Address - Fax:229-883-6498
Is Sole Proprietor?:No
Enumeration Date:2016-09-28
Last Update Date:2016-09-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GARPH021767183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist