Provider Demographics
NPI:1558889022
Name:BAXLEY, EMILY ANN (PHARMD)
Entity Type:Individual
Prefix:
First Name:EMILY
Middle Name:ANN
Last Name:BAXLEY
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 1:3810 BUCK LAKE RD APT C306
Mailing Address - Street 2:
Mailing Address - City:TALLAHASSEE
Mailing Address - State:FL
Mailing Address - Zip Code:32317-9441
Mailing Address - Country:US
Mailing Address - Phone:850-340-0855
Mailing Address - Fax:
Practice Address - Street 1:800 OCALA RD
Practice Address - Street 2:
Practice Address - City:TALLAHASSEE
Practice Address - State:FL
Practice Address - Zip Code:32304-1669
Practice Address - Country:US
Practice Address - Phone:850-575-3929
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-09-05
Last Update Date:2017-09-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPS57031183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist