Provider Demographics
NPI:1962099184
Name:PARKER, LAUREN KYLEIGH (PHARMD)
Entity type:Individual
Prefix:MRS
First Name:LAUREN
Middle Name:KYLEIGH
Last Name:PARKER
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 1:4710 WINDSOR PARK LN
Mailing Address - Street 2:
Mailing Address - City:PANAMA CITY
Mailing Address - State:FL
Mailing Address - Zip Code:32404-2114
Mailing Address - Country:US
Mailing Address - Phone:859-421-3144
Mailing Address - Fax:
Practice Address - Street 1:3104 W 23RD ST
Practice Address - Street 2:
Practice Address - City:PANAMA CITY
Practice Address - State:FL
Practice Address - Zip Code:32405-1829
Practice Address - Country:US
Practice Address - Phone:850-215-7455
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-12-22
Last Update Date:2020-12-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPS58375183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist