Healthcare Provider Details

I. General information

NPI: 1124877303
Provider Name (Legal Business Name): SARAH ELIZABETH DUNCAN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/18/2024
Last Update Date: 05/18/2024
Certification Date: 05/18/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

120 N HIGHWAY 171
MOSS BLUFF LA
70611-5343
US

IV. Provider business mailing address

120 N HIGHWAY 171
MOSS BLUFF LA
70611-5343
US

V. Phone/Fax

Practice location:
  • Phone: 337-855-4848
  • Fax:
Mailing address:
  • Phone: 337-855-4848
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License NumberPST.025276
License Number StateLA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: