Provider Demographics
NPI:1073181863
Name:DOCKENS, HALEIGH (PHARMD)
Entity Type:Individual
Prefix:
First Name:HALEIGH
Middle Name:
Last Name:DOCKENS
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:266 RAE RD
Mailing Address - Street 2:
Mailing Address - City:MANY
Mailing Address - State:LA
Mailing Address - Zip Code:71449-6906
Mailing Address - Country:US
Mailing Address - Phone:318-780-4961
Mailing Address - Fax:
Practice Address - Street 1:280 SAN ANTONIO AVE
Practice Address - Street 2:
Practice Address - City:MANY
Practice Address - State:LA
Practice Address - Zip Code:71449-3011
Practice Address - Country:US
Practice Address - Phone:318-590-9821
Practice Address - Fax:318-590-9827
Is Sole Proprietor?:No
Enumeration Date:2021-06-16
Last Update Date:2021-08-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LAPNT.048506390200000X
LAPST.0239831835P0018X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1835P0018XPharmacy Service ProvidersPharmacistPharmacist Clinician (PhC)/ Clinical Pharmacy Specialist
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program