Provider Demographics
NPI:1073803342
Name:ADKINS, AMY (PHARMD)
Entity Type:Individual
Prefix:MRS
First Name:AMY
Middle Name:
Last Name:ADKINS
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 1:10560 SHADOWLAKE DR
Mailing Address - Street 2:
Mailing Address - City:GEISMAR
Mailing Address - State:LA
Mailing Address - Zip Code:70734-3329
Mailing Address - Country:US
Mailing Address - Phone:225-644-0479
Mailing Address - Fax:
Practice Address - Street 1:7570 JEFFERSON HWY
Practice Address - Street 2:
Practice Address - City:BATON ROUGE
Practice Address - State:LA
Practice Address - Zip Code:70806-8307
Practice Address - Country:US
Practice Address - Phone:225-927-4411
Practice Address - Fax:225-231-2354
Is Sole Proprietor?:No
Enumeration Date:2011-04-07
Last Update Date:2011-04-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA17462183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist