Provider Demographics
NPI:1891031142
Name:PATTERSON, SHIONKA S (PHARM D)
Entity Type:Individual
Prefix:MS
First Name:SHIONKA
Middle Name:S
Last Name:PATTERSON
Suffix:
Gender:F
Credentials:PHARM D
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:120 N HIGHWAY 171
Mailing Address - Street 2:
Mailing Address - City:MOSS BLUFF
Mailing Address - State:LA
Mailing Address - Zip Code:70611-5343
Mailing Address - Country:US
Mailing Address - Phone:337-855-4848
Mailing Address - Fax:337-855-8631
Practice Address - Street 1:120 N HIGHWAY 171
Practice Address - Street 2:
Practice Address - City:MOSS BLUFF
Practice Address - State:LA
Practice Address - Zip Code:70611-5343
Practice Address - Country:US
Practice Address - Phone:337-855-4848
Practice Address - Fax:337-855-8631
Is Sole Proprietor?:No
Enumeration Date:2012-12-13
Last Update Date:2012-12-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA019963183500000X
LAMA 1968183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist