Provider Demographics
NPI:1073349767
Name:THURMAN, NITA LARAE (PHARM D)
Entity type:Individual
Prefix:
First Name:NITA
Middle Name:LARAE
Last Name:THURMAN
Suffix:
Gender:F
Credentials:PHARM D
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:21503 KATE LN
Mailing Address - Street 2:
Mailing Address - City:HENSLEY
Mailing Address - State:AR
Mailing Address - Zip Code:72065-9160
Mailing Address - Country:US
Mailing Address - Phone:501-454-2024
Mailing Address - Fax:
Practice Address - Street 1:3028 E WOODSON LATERAL RD
Practice Address - Street 2:
Practice Address - City:HENSLEY
Practice Address - State:AR
Practice Address - Zip Code:72065-9169
Practice Address - Country:US
Practice Address - Phone:501-486-4131
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-09-10
Last Update Date:2024-09-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ARPD08648183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist