Provider Demographics
NPI:1669758371
Name:READY, SHAKERA RENETTE (PHARMD)
Entity type:Individual
Prefix:MS
First Name:SHAKERA
Middle Name:RENETTE
Last Name:READY
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 1:9100 PEACH TREE LN
Mailing Address - Street 2:
Mailing Address - City:SHERWOOD
Mailing Address - State:AR
Mailing Address - Zip Code:72120-3900
Mailing Address - Country:US
Mailing Address - Phone:501-835-5092
Mailing Address - Fax:
Practice Address - Street 1:5917 BASELINE RD
Practice Address - Street 2:
Practice Address - City:LITTLE ROCK
Practice Address - State:AR
Practice Address - Zip Code:72209-5046
Practice Address - Country:US
Practice Address - Phone:501-565-7844
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-10-26
Last Update Date:2011-10-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ARPD11499183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist