Provider Demographics
NPI:1770346678
Name:COLLARD, ERIN LYNN (PHARMD)
Entity type:Individual
Prefix:
First Name:ERIN
Middle Name:LYNN
Last Name:COLLARD
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 1:2202 PORT TOWNSEND CT
Mailing Address - Street 2:
Mailing Address - City:COLUMBIA
Mailing Address - State:MO
Mailing Address - Zip Code:65203-8473
Mailing Address - Country:US
Mailing Address - Phone:417-861-4810
Mailing Address - Fax:
Practice Address - Street 1:2613 FAIRWAY DR STE C
Practice Address - Street 2:
Practice Address - City:FULTON
Practice Address - State:MO
Practice Address - Zip Code:65251-3789
Practice Address - Country:US
Practice Address - Phone:573-642-1990
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-02-02
Last Update Date:2024-02-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO20190335201835P2201X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1835P2201XPharmacy Service ProvidersPharmacistAmbulatory Care