Provider Demographics
NPI:1245834431
Name:STRICKLEN, AMANDA D (PHARMD)
Entity type:Individual
Prefix:DR
First Name:AMANDA
Middle Name:D
Last Name:STRICKLEN
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 1:301 AMERICAN AVE
Mailing Address - Street 2:
Mailing Address - City:BOONEVILLE
Mailing Address - State:MS
Mailing Address - Zip Code:38829-1019
Mailing Address - Country:US
Mailing Address - Phone:662-720-1707
Mailing Address - Fax:
Practice Address - Street 1:301 AMERICAN AVE
Practice Address - Street 2:
Practice Address - City:BOONEVILLE
Practice Address - State:MS
Practice Address - Zip Code:38829-1019
Practice Address - Country:US
Practice Address - Phone:662-720-1707
Practice Address - Fax:662-720-1708
Is Sole Proprietor?:No
Enumeration Date:2020-11-28
Last Update Date:2020-11-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MSE010524183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist