Dianna Bardot, RPH
Individual provider Active NPI Pharmacist · Leadington, MO
NPI 1366048910 · NPPES record last updated Dec 9, 2020
Key facts
- NPI
- 1366048910
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Pharmacist 183500000X
- License
- 043639 (MO)
- Practice address
- 113 Saint Francois PLZ
Leadington, MO 63601-4454 - Phone
- (573) 431-8575
- NPI assigned
- Dec 9, 2020
- Sex
- Female
- Sole proprietor
- Yes
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
- Credentials
- Registered Pharmacist
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 043639 | MO | MD | Pharmacist |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pharmacist | 183500000X | 043639 | MO | Yes |
Addresses
Primary practice location
113 Saint Francois PLZ
Leadington, MO 63601-4454
Mailing address
113 Saint Francois PLZ
Leadington, MO 63601-4454
Phone (573) 431-8575
Other providers in Leadington, MO
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Dec 9, 2020. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.