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General NPI Number Information
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NPI Number | 1902467863
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Entity Type | Individual
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Provider Name | BRITTNEY WALTERS
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Gender | Female
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Dates
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Enumeration Date | 06/21/2019
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Last Update Date | 11/27/2023
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Provider Practice Location Address
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Address Line | 2996 CHURCH RD E
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City | SOUTHAVEN
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State | MS
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Zip | 38671-9825
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Country | US
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Telephone | 662-349-4418
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Fax |
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Provider Business Mailing Address
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Address Line | 888 CROCKETT LOOP N
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City | HERNANDO
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State | MS
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Zip | 38632-6530
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Country | US
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Telephone | 901-598-0722
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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 | 183500000X
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Taxonomy Name | Pharmacist
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License Number | 07708
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License Number State | MS
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