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NPI Code Detail

MEDICARE: AMANDA R HARPER

MEDICARE: AMANDA R HARPER
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1183500000XPharmacistE-11707MS

General Provider Information

NPI Number : 1669076048
Entity Type Code : Individual
Provider Name (Legal Business Name) : AMANDA R HARPER
Provider Business Mailing Address
First Line : 74 COUNTY ROAD 1713
Second Line :
City : BAY SPRINGS
State : MS
Zip : 39422-9450
Country : US
Telephone Number : 601-670-6831
Fax Number :
Provider Business Practice Location Address
First Line : 1621 HIGHWAY 15 N
Second Line :
City : LAUREL
State : MS
Zip : 39440-2123
Country : US
Telephone Number : 601-649-4670
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 11/25/2020
Last Update Date : 11/25/2020

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Directions to “ AMANDA R HARPER ” Practice Location

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