Provider Demographics
NPI:1841997665
Name:BLAIR, AMANDA ADKINS (PHARMD)
Entity type:Individual
Prefix:
First Name:AMANDA
Middle Name:ADKINS
Last Name:BLAIR
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:PO BOX 492
Mailing Address - Street 2:
Mailing Address - City:SANDY HOOK
Mailing Address - State:KY
Mailing Address - Zip Code:41171-0492
Mailing Address - Country:US
Mailing Address - Phone:606-738-4041
Mailing Address - Fax:606-738-4030
Practice Address - Street 1:432 S KY 7
Practice Address - Street 2:
Practice Address - City:SANDY HOOK
Practice Address - State:KY
Practice Address - Zip Code:41171-8132
Practice Address - Country:US
Practice Address - Phone:606-738-4041
Practice Address - Fax:606-738-4030
Is Sole Proprietor?:No
Enumeration Date:2023-02-13
Last Update Date:2023-02-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY019992183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist