Provider Demographics
NPI:1225632672
Name:SKINNER, AMY LOWREY (PHARMD)
Entity Type:Individual
Prefix:
First Name:AMY
Middle Name:LOWREY
Last Name:SKINNER
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 1:301 AMERICAN AVE
Mailing Address - Street 2:
Mailing Address - City:BOONEVILLE
Mailing Address - State:MS
Mailing Address - Zip Code:38829-1019
Mailing Address - Country:US
Mailing Address - Phone:662-720-1707
Mailing Address - Fax:662-720-1708
Practice Address - Street 1:301 AMERICAN AVE
Practice Address - Street 2:
Practice Address - City:BOONEVILLE
Practice Address - State:MS
Practice Address - Zip Code:38829-1019
Practice Address - Country:US
Practice Address - Phone:662-720-1707
Practice Address - Fax:662-720-1708
Is Sole Proprietor?:No
Enumeration Date:2020-11-25
Last Update Date:2020-11-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MSE-12667183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist