Provider Demographics
NPI:1457609455
Name:BLAKE, BRITTANY ANN (PHARMD)
Entity Type:Individual
Prefix:DR
First Name:BRITTANY
Middle Name:ANN
Last Name:BLAKE
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:MISS
Other - First Name:BRITTANY
Other - Middle Name:ANN
Other - Last Name:WINFREY
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:4184 STONECREST DR
Mailing Address - Street 2:APT # 102
Mailing Address - City:BURLINGTON
Mailing Address - State:NC
Mailing Address - Zip Code:27215-7829
Mailing Address - Country:US
Mailing Address - Phone:336-391-9433
Mailing Address - Fax:336-449-0879
Practice Address - Street 1:6310 BURLINGTON RD
Practice Address - Street 2:
Practice Address - City:WHITSETT
Practice Address - State:NC
Practice Address - Zip Code:27377-9233
Practice Address - Country:US
Practice Address - Phone:336-449-0294
Practice Address - Fax:336-449-0879
Is Sole Proprietor?:No
Enumeration Date:2012-08-22
Last Update Date:2012-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC22482183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist