Provider Demographics
NPI:1962203299
Name:KIRKLAND, ASHLYNN BROOKE
Entity type:Individual
Prefix:
First Name:ASHLYNN
Middle Name:BROOKE
Last Name:KIRKLAND
Suffix:
Gender:
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:20 MYSTERY LN
Mailing Address - Street 2:
Mailing Address - City:CARRIERE
Mailing Address - State:MS
Mailing Address - Zip Code:39426-9034
Mailing Address - Country:US
Mailing Address - Phone:601-273-7835
Mailing Address - Fax:
Practice Address - Street 1:510 S MAIN ST
Practice Address - Street 2:
Practice Address - City:POPLARVILLE
Practice Address - State:MS
Practice Address - Zip Code:39470-3023
Practice Address - Country:US
Practice Address - Phone:601-798-4846
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-03-22
Last Update Date:2025-03-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MSE-101875183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist