Provider Demographics
NPI:1497858484
Name:KITCHENS, ROSAMAEND ILIZABETH (RPH)
Entity Type:Individual
Prefix:
First Name:ROSAMAEND
Middle Name:ILIZABETH
Last Name:KITCHENS
Suffix:
Gender:F
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:52 PINE SQUARE
Mailing Address - Street 2:
Mailing Address - City:HAMMOND
Mailing Address - State:LA
Mailing Address - Zip Code:70401
Mailing Address - Country:US
Mailing Address - Phone:985-419-9767
Mailing Address - Fax:
Practice Address - Street 1:3925 HIGHWAY 190 W
Practice Address - Street 2:
Practice Address - City:HAMMOND
Practice Address - State:LA
Practice Address - Zip Code:70401-4981
Practice Address - Country:US
Practice Address - Phone:985-549-6886
Practice Address - Fax:985-549-6857
Is Sole Proprietor?:No
Enumeration Date:2006-09-06
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA15205183500000X
MST-09853183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist
Provider Identifiers
StateIdentifier IDID TypeIssuer
LA15205OtherPHARMACIST LICENSE NUMBER
MST-09853OtherPHARMACIST LICENSE NUMBER