Provider Demographics
NPI:1639416993
Name:HULL, DENIKKA LATOYA
Entity Type:Individual
Prefix:DR
First Name:DENIKKA
Middle Name:LATOYA
Last Name:HULL
Suffix:
Gender:F
Credentials:
Other - Prefix:DR
Other - First Name:DENIKKA
Other - Middle Name:LATOYA
Other - Last Name:HULL-BLACKMON
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:PHARMD
Mailing Address - Street 1:12506 HIGHWAY 73
Mailing Address - Street 2:
Mailing Address - City:GEISMAR
Mailing Address - State:LA
Mailing Address - Zip Code:70734-3209
Mailing Address - Country:US
Mailing Address - Phone:225-677-7607
Mailing Address - Fax:
Practice Address - Street 1:12506 HIGHWAY 73
Practice Address - Street 2:
Practice Address - City:GEISMAR
Practice Address - State:LA
Practice Address - Zip Code:70734-3209
Practice Address - Country:US
Practice Address - Phone:225-677-7607
Practice Address - Fax:225-677-7608
Is Sole Proprietor?:No
Enumeration Date:2013-01-07
Last Update Date:2023-01-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LAPST.16636183500000X
LA016636183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist