Provider Demographics
NPI:1831472257
Name:BAKKER, ADRIAN WEBB (PHARMD)
Entity type:Individual
Prefix:
First Name:ADRIAN
Middle Name:WEBB
Last Name:BAKKER
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 1:412 E MAIN ST
Mailing Address - Street 2:
Mailing Address - City:LOUISA
Mailing Address - State:VA
Mailing Address - Zip Code:23093-6518
Mailing Address - Country:US
Mailing Address - Phone:540-967-0771
Mailing Address - Fax:540-967-4993
Practice Address - Street 1:412 E MAIN ST
Practice Address - Street 2:
Practice Address - City:LOUISA
Practice Address - State:VA
Practice Address - Zip Code:23093-6518
Practice Address - Country:US
Practice Address - Phone:540-967-0771
Practice Address - Fax:540-967-4993
Is Sole Proprietor?:No
Enumeration Date:2011-09-21
Last Update Date:2011-09-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0202209931183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist