Provider Demographics
NPI:1316075237
Name:IRVIN, EMILY PATRICE (PHARM D)
Entity type:Individual
Prefix:DR
First Name:EMILY
Middle Name:PATRICE
Last Name:IRVIN
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 1:14141 MEADOW BROOK LN
Mailing Address - Street 2:
Mailing Address - City:WALKER
Mailing Address - State:LA
Mailing Address - Zip Code:70785-6413
Mailing Address - Country:US
Mailing Address - Phone:225-667-5537
Mailing Address - Fax:
Practice Address - Street 1:28145 WALKER RD S
Practice Address - Street 2:
Practice Address - City:WALKER
Practice Address - State:LA
Practice Address - Zip Code:70785-6027
Practice Address - Country:US
Practice Address - Phone:225-791-5640
Practice Address - Fax:225-791-5611
Is Sole Proprietor?:No
Enumeration Date:2007-03-01
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA17184183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist