Provider Demographics
NPI:1184972606
Name:YATES, CAROLYN B (PHARM D)
Entity type:Individual
Prefix:
First Name:CAROLYN
Middle Name:B
Last Name:YATES
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 1:1125 HIGHWAY 80
Mailing Address - Street 2:
Mailing Address - City:HAUGHTON
Mailing Address - State:LA
Mailing Address - Zip Code:71037-9430
Mailing Address - Country:US
Mailing Address - Phone:318-949-8476
Mailing Address - Fax:
Practice Address - Street 1:1125 HIGHWAY 80
Practice Address - Street 2:
Practice Address - City:HAUGHTON
Practice Address - State:LA
Practice Address - Zip Code:71037-9430
Practice Address - Country:US
Practice Address - Phone:318-949-8476
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-08-15
Last Update Date:2012-08-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA17145183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist
Provider Identifiers
StateIdentifier IDID TypeIssuer
LA17145OtherLOUISIANA BOARD OF PHARMACY