Provider Demographics
NPI:1609591544
Name:BARKSDALE, BRITTANI SHANE (PHARMD)
Entity Type:Individual
Prefix:
First Name:BRITTANI
Middle Name:SHANE
Last Name:BARKSDALE
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:PO BOX 622
Mailing Address - Street 2:
Mailing Address - City:ROBERT
Mailing Address - State:LA
Mailing Address - Zip Code:70455-0622
Mailing Address - Country:US
Mailing Address - Phone:985-662-8590
Mailing Address - Fax:
Practice Address - Street 1:25497 HWY 190 E
Practice Address - Street 2:
Practice Address - City:ROBERT
Practice Address - State:LA
Practice Address - Zip Code:70455-0622
Practice Address - Country:US
Practice Address - Phone:985-662-8590
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-10-04
Last Update Date:2022-10-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LAPST.024566183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist