Amy Michele Burnquist, PHARM.D
Individual provider Active NPI Pharmacist · Las Vegas, NM
NPI 1801100458 · NPPES record last updated Aug 5, 2010
Key facts
- NPI
- 1801100458
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Pharmacist 183500000X
- License
- RP00006909 (NM)
- Practice address
- 620 Mills Avenue
Walgreens Pharmacy
Las Vegas, NM 87701-4671 - Phone
- (505) 425-3317
- Fax
- (505) 425-3348
- NPI assigned
- Aug 5, 2010
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 2
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 |
|---|---|---|---|
| RP00006909 | NM | MD | Pharmacist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Walgreen Co | Past |
Accepting new patients | |
| Walgreen Co | Past | Accepting new patients |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pharmacist | 183500000X | RP00006909 | NM | Yes |
Addresses
Primary practice location
620 Mills Avenue
Walgreens Pharmacy
Las Vegas, NM 87701-4671
Mailing address
620 Mills Avenue
Walgreens Pharmacy
Las Vegas, NM 87701-4671
Phone (505) 425-3317
Other providers in Las Vegas, NM
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Aug 5, 2010. 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.