Provider Demographics
NPI:1558985499
Name:AKINYOKUNBO, TANITA L (PHARMD)
Entity Type:Individual
Prefix:
First Name:TANITA
Middle Name:L
Last Name:AKINYOKUNBO
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 1:156 CLOVER POINT CIR
Mailing Address - Street 2:
Mailing Address - City:GUYTON
Mailing Address - State:GA
Mailing Address - Zip Code:31312-7134
Mailing Address - Country:US
Mailing Address - Phone:912-250-9740
Mailing Address - Fax:
Practice Address - Street 1:156 CLOVER POINT CIR
Practice Address - Street 2:
Practice Address - City:GUYTON
Practice Address - State:GA
Practice Address - Zip Code:31312-7134
Practice Address - Country:US
Practice Address - Phone:912-250-9740
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-06-06
Last Update Date:2020-06-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care