Provider Demographics
NPI:1598063638
Name:WHITFIELD-PARKER, MALETA NASHON (PHARMD)
Entity Type:Individual
Prefix:DR
First Name:MALETA
Middle Name:NASHON
Last Name:WHITFIELD-PARKER
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 1:7250 SIGHTSEEING ROAD
Mailing Address - Street 2:BUILDING 2515
Mailing Address - City:FORT MOORE
Mailing Address - State:GA
Mailing Address - Zip Code:31905
Mailing Address - Country:US
Mailing Address - Phone:706-544-2829
Mailing Address - Fax:
Practice Address - Street 1:7250 SIGHTSEEING ROAD
Practice Address - Street 2:BUILDING 2515
Practice Address - City:FORT MOORE
Practice Address - State:GA
Practice Address - Zip Code:31905
Practice Address - Country:US
Practice Address - Phone:706-544-2829
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-03-13
Last Update Date:2024-02-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL14693183500000X
GARPH022779183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist