Kenyarda Durden, PHARMD
Individual provider Active NPI Pharmacist · Lake Park, GA
NPI 1730645375 · NPPES record last updated Feb 19, 2019
Key facts
- NPI
- 1730645375
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Pharmacist 183500000X
- License
- RPH-031111 (GA)
- Practice address
- 1060 Lakes Blvd
Lake Park, GA 31636-3013 - Phone
- (229) 559-7736
- NPI assigned
- Feb 19, 2019
- 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 |
|---|---|---|---|
| RPH-031111 | GA | MD | Pharmacist |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pharmacist | 183500000X | RPH-031111 | GA | Yes |
Addresses
Primary practice location
1060 Lakes Blvd
Lake Park, GA 31636-3013
Mailing address
1060 Lakes Blvd
Lake Park, GA 31636-3013
Phone (229) 559-7736
Other providers in Lake Park, GA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Feb 19, 2019. 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.