Provider Demographics
NPI:1962032474
Name:REAGAN, ADRIANNA TAYLOR (PHARMD)
Entity Type:Individual
Prefix:
First Name:ADRIANNA
Middle Name:TAYLOR
Last Name:REAGAN
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 1:74 LEE ROAD 2138
Mailing Address - Street 2:
Mailing Address - City:PHENIX CITY
Mailing Address - State:AL
Mailing Address - Zip Code:36870-1007
Mailing Address - Country:US
Mailing Address - Phone:706-325-2602
Mailing Address - Fax:
Practice Address - Street 1:2000 PEPPERELL PKWY
Practice Address - Street 2:
Practice Address - City:OPELIKA
Practice Address - State:AL
Practice Address - Zip Code:36801-5422
Practice Address - Country:US
Practice Address - Phone:706-325-2602
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-01-23
Last Update Date:2023-07-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL226531835E0208X
ALS12721390200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1835E0208XPharmacy Service ProvidersPharmacistEmergency Medicine
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program