Provider Demographics
NPI:1124369897
Name:KAY, AMANDA J (PHARMD)
Entity Type:Individual
Prefix:
First Name:AMANDA
Middle Name:J
Last Name:KAY
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 1:7110 YOUREE DR
Mailing Address - Street 2:T-1347
Mailing Address - City:SHREVEPORT
Mailing Address - State:LA
Mailing Address - Zip Code:71105-5107
Mailing Address - Country:US
Mailing Address - Phone:318-798-7860
Mailing Address - Fax:318-517-6426
Practice Address - Street 1:7110 YOUREE DR
Practice Address - Street 2:T-1347
Practice Address - City:SHREVEPORT
Practice Address - State:LA
Practice Address - Zip Code:71105-5107
Practice Address - Country:US
Practice Address - Phone:318-798-7860
Practice Address - Fax:318-517-6426
Is Sole Proprietor?:Yes
Enumeration Date:2013-03-06
Last Update Date:2013-03-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX43224183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist