Provider Demographics
NPI:1811271638
Name:BURKETT, LAURIE PRATHER (PHARMD)
Entity type:Individual
Prefix:MRS
First Name:LAURIE
Middle Name:PRATHER
Last Name:BURKETT
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 1:3200 HIGHLAND ROAD
Mailing Address - Street 2:
Mailing Address - City:BATON ROUGE
Mailing Address - State:LA
Mailing Address - Zip Code:70802
Mailing Address - Country:US
Mailing Address - Phone:225-388-9939
Mailing Address - Fax:225-388-9940
Practice Address - Street 1:3200 HIGHLAND RD
Practice Address - Street 2:
Practice Address - City:BATON ROUGE
Practice Address - State:LA
Practice Address - Zip Code:70802-7917
Practice Address - Country:US
Practice Address - Phone:225-388-9939
Practice Address - Fax:225-388-9940
Is Sole Proprietor?:No
Enumeration Date:2011-09-29
Last Update Date:2011-09-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA018213183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist