Individual
HAILEY AMANDA WHITAKER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PHARMD
Contact information
Practice address
4900 E MAIN ST, FARMINGTON, NM 87402-8658
(505) 327-3555
Mailing address
4407 PACIFIC ST, FARMINGTON, NM 87402-1727
(913) 558-0592
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
RP00009366
NM
Other
Enumeration date
10/16/2020
Last updated
10/16/2020
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