Data from the NPPES registry. May not reflect recent changes — verify at nppes.cms.hhs.gov.
MRS. DETRA ELAINE PROVOST, RPH
ActiveMRS. DETRA ELAINE PROVOST, RPH is a Pharmacist healthcare provider located in EVANS, Georgia. NPI 1265703128 is currently active in the NPPES registry. Verify at CMS.
Pharmacist · EVANS, GA
Registration Details
- NPI Number
- 1265703128
- Provider Type
- Individual
- Gender
- Female
- NPI Issued
- Jan 24, 2012 (14.533363341642 yrs)
- Last Updated
- Jan 24, 2012
- Licenses
-
RPH18214 (GA)8706 (SC)32754 (TX)
Practice Information
- Address
-
4223 WASHINGTON RDEVANS, GA, 308093069Browse GA providers · Browse ZIP 30809
- Phone
- 7068690937
- Fax
- 7069939781
- Primary Specialty
-
Pharmacist
183500000X
- Additional Specialty
- Pharmacist
- Additional Specialty
- Pharmacist
Other Pharmacist Providers in EVANS, GA
| Name | Credential | NPI |
|---|---|---|
| MR. LARRY MATHIS | — | 1639283930 |
| EPIFANIO RAMOS | PHARMACIST | 1164520276 |
| KYLE W PULLIAM | RPH | 1306986906 |
| DONNETTA L HEROLD | RPH | 1265561302 |
| MR. CHRISTOPHER PATRICK PARKER | RPH | 1457565004 |
| MS. WYLESIA RENA WHITE | PHARMD | 1679753065 |
Data sourced from the NPPES National Provider Identifier registry. This information is for informational purposes only and is not a substitute for verifying credentials with the appropriate licensing authority. For official verification, use the NPPES NPI Registry or the relevant state medical board.