Provider Demographics
NPI:1699393314
Name:BREEDEN, ELIZABETH BAILEY (PHARMD)
Entity Type:Individual
Prefix:
First Name:ELIZABETH
Middle Name:BAILEY
Last Name:BREEDEN
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 1:16021 W 82ND TER
Mailing Address - Street 2:
Mailing Address - City:LENEXA
Mailing Address - State:KS
Mailing Address - Zip Code:66219-1629
Mailing Address - Country:US
Mailing Address - Phone:913-302-2642
Mailing Address - Fax:
Practice Address - Street 1:320 EMERGENCY ROOM DRIVE JAMES TAYLOR BUILDING CB #7470
Practice Address - Street 2:
Practice Address - City:CHAPEL HILL
Practice Address - State:NC
Practice Address - Zip Code:27599-0001
Practice Address - Country:US
Practice Address - Phone:919-966-6554
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-07-09
Last Update Date:2020-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC29702183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist