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General NPI Number Information
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NPI Number | 1881557320
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Entity Type | Individual
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Provider Name | KEISHA PHILLIPS BARDEN
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Gender | Female
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Dates
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Enumeration Date | 12/03/2025
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Last Update Date | 12/03/2025
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Provider Practice Location Address
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Address Line | 4344 CHURCH ST
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City | ZACHARY
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State | LA
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Zip | 70791-3102
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Country | US
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Telephone | 225-654-1175
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Fax |
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Provider Business Mailing Address
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Address Line | 4192 HONEYSUCKLE DR
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City | ZACHARY
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State | LA
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Zip | 70791-2765
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Country | US
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Telephone | 225-681-6447
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 183700000X
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Taxonomy Name | Pharmacy Technician
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License Number | M4C3E2X9
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License Number State | LA
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