Amy Elizabeth Bixler
Individual provider Active NPI Pharmacist · Brookhaven, GA
NPI 1861900755 · NPPES record last updated Jan 14, 2018
Key facts
- NPI
- 1861900755
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Pharmacist 183500000X
- License
- 14699 (NV)
- Practice address
- 1200 Lake Hearn Dr NE Ste 425
Brookhaven, GA 30319-6419 - Phone
- (757) 450-0161
- NPI assigned
- Jan 14, 2018
- 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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 14699 | NV | MD | Pharmacist |
| 0202206795 | VA | MD | Pharmacist |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pharmacist | 183500000X | 0202206795 | VA | |
| Pharmacist | 183500000X | 14699 | NV | Yes |
Addresses
Primary practice location
1200 Lake Hearn Dr NE Ste 425
Brookhaven, GA 30319-6419
Mailing address
1200 Lake Hearn Dr NE Ste 425
Brookhaven, GA 30319-6419
Phone (757) 450-0161
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 14699 | Other | NV | PHARMACIST |
Other providers in Brookhaven, GA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jan 14, 2018. 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.