Provider Demographics
NPI:1710254248
Name:AKINS, MIA MICHELLE (RPH)
Entity Type:Individual
Prefix:MRS
First Name:MIA
Middle Name:MICHELLE
Last Name:AKINS
Suffix:
Gender:F
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6717 BREEZE POINTE DR
Mailing Address - Street 2:
Mailing Address - City:WHITSETT
Mailing Address - State:NC
Mailing Address - Zip Code:27377-9122
Mailing Address - Country:US
Mailing Address - Phone:336-603-4297
Mailing Address - Fax:
Practice Address - Street 1:1040 ALAMANCE CHURCH RD
Practice Address - Street 2:
Practice Address - City:GREENSBORO
Practice Address - State:NC
Practice Address - Zip Code:27406-3808
Practice Address - Country:US
Practice Address - Phone:336-272-4121
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-11-29
Last Update Date:2011-11-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC183500000X1835P1200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1835P1200XPharmacy Service ProvidersPharmacistPharmacotherapy