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General NPI Number Information
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NPI Number | 1942891692
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Entity Type | Individual
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Provider Name | BREANNA A LOCKE PHARMD
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Gender | Female
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Dates
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Enumeration Date | 01/26/2021
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Last Update Date | 01/26/2021
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Provider Practice Location Address
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Address Line | 178 BRACKETTS WAY STE 7
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City | BLAIRSVILLE
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State | GA
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Zip | 30512-2984
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Country | US
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Telephone | 706-400-5043
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Fax | 706-400-5046
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Provider Business Mailing Address
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Address Line | 1232 BELL HILL RD
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City | MURPHY
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State | NC
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Zip | 28906-7328
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Country | US
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Telephone | 828-557-0130
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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 | 031442
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License Number State | GA
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