Individual
HOLLY BURKE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PHARMACIST
Contact information
Practice address
3615 SANGANI BLVD, DIBERVILLE, MS 39540-8770
(228) 396-4778
(228) 396-0129
Mailing address
3615 SANGANI BLVD, DIBERVILLE, MS 39540-8770
(228) 396-4778
(228) 396-0129
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
E07308
MS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
E07308
PHARMACY LICENSE
MS
Enumeration date
09/02/2015
Last updated
09/02/2015
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