Brequia Bozeman

Primary specialty

Pharmacist Clinician (PhC)/ Clinical Pharmacy SpecialistTaxonomy code 1835P0018X

License

E-100921 Issued in MS

Practice address

7251 Interstate Dr
Horn Lake, MS 38637-1410

Phone

(662) 349-8336

NPI assigned

Oct 20, 2022

Last updated

Oct 20, 2022By the provider in NPPES

Sex

Female

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Kroger Limited Partnership I

  dba Kroger Pharmacy

  • Community/Retail Pharmacy
  • Horn Lake, MS
  • NPI 1104850981
  NPD (past)
• Kroger Limited Partnership I

  dba Kroger Pharmacy #473

  • Community/Retail Pharmacy
  • Newport, KY
  • NPI 1104791078
  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1666224000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1666224000000",
    "number": "1073230132",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7251 INTERSTATE DR",
            "city": "HORN LAKE",
            "state": "MS",
            "postal_code": "386371410"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7251 INTERSTATE DR",
            "city": "HORN LAKE",
            "state": "MS",
            "postal_code": "386371410",
            "telephone_number": "662-349-8336"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BOZEMAN",
        "first_name": "BREQUIA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-10-20",
        "last_updated": "2022-10-20",
        "certification_date": "2022-10-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1835P0018X",
            "taxonomy_group": "",
            "desc": "Pharmacist, Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist",
            "state": "AR",
            "license": "PD16310",
            "primary": false
        },
        {
            "code": "1835P0018X",
            "taxonomy_group": "",
            "desc": "Pharmacist, Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist",
            "state": "MS",
            "license": "E-100921",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Hailey Becnel, PHARMD
• Joshua Bell, RPH
• Tavoiya Monique Bell, LPC-MHSPT, NCC
• Big River Chiropractic Horn Lake PLLC
• John Bowen
• Anjali Patel Brahmbhatt, DDS
• Melissa A Breitling, MD
• Pamela Breland, APRNBC, FNP
• Kelsey J Bryant, SLP
• Tekela Lashay Campbell, FNP

• Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist in Horn Lake, MS
• Providers in Horn Lake, MS by specialty
• Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist in Mississippi

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 20, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.