Provider Demographics
NPI:1518577279
Name:DUNCAN, KIANA
Entity Type:Individual
Prefix:
First Name:KIANA
Middle Name:
Last Name:DUNCAN
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:120 N HIGHWAY 171
Mailing Address - Street 2:
Mailing Address - City:MOSS BLUFF
Mailing Address - State:LA
Mailing Address - Zip Code:70611-5343
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:120 N HIGHWAY 171
Practice Address - Street 2:
Practice Address - City:MOSS BLUFF
Practice Address - State:LA
Practice Address - Zip Code:70611-5343
Practice Address - Country:US
Practice Address - Phone:337-855-4848
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-08-06
Last Update Date:2020-08-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA023518183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist