Provider Demographics
NPI:1518249549
Name:MARKEY, DWAINA BRIMMER (PHARMD)
Entity Type:Individual
Prefix:DR
First Name:DWAINA
Middle Name:BRIMMER
Last Name:MARKEY
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:DR
Other - First Name:DWAINA
Other - Middle Name:CATRICE
Other - Last Name:BRIMMER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PHARMD
Mailing Address - Street 1:PO BOX 50
Mailing Address - Street 2:1313 PAUL MALLARD SUITE A
Mailing Address - City:LULING
Mailing Address - State:LA
Mailing Address - Zip Code:70070-0050
Mailing Address - Country:US
Mailing Address - Phone:985-785-1753
Mailing Address - Fax:985-785-9784
Practice Address - Street 1:1313 PAUL MAILLARD RD
Practice Address - Street 2:SUITE A
Practice Address - City:LULING
Practice Address - State:LA
Practice Address - Zip Code:70070-4549
Practice Address - Country:US
Practice Address - Phone:985-785-1753
Practice Address - Fax:985-785-9784
Is Sole Proprietor?:No
Enumeration Date:2011-09-15
Last Update Date:2011-09-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA16631183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist