Nikosha Anderson, PHARMD
Individual provider Active NPI Pharmacist · Leesville, LA
NPI 1669923504 · NPPES record last updated Oct 15, 2016
Key facts
- NPI
- 1669923504
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Pharmacist 183500000X
- License
- SWP.000676 (LA)
- Practice address
- 2204 S 5TH St
Leesville, LA 71446-5318 - Phone
- (337) 238-9305
- NPI assigned
- Oct 15, 2016
- Sex
- Female
- Sole proprietor
- No
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
- Credentials
- Doctor of Pharmacy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| SWP.000676 | LA | MD | Pharmacist |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pharmacist | 183500000X | SWP.000676 | LA | Yes |
Addresses
Primary practice location
2204 S 5TH St
Leesville, LA 71446-5318
Mailing address
6322 Noldan PL Apt B
Fort Polk, LA 71459-7440
Other providers in Leesville, LA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Oct 15, 2016. 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.