DR. JORDAN LYNN BRAZEAL (NPI# 1568730091) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
Nation Provider ID (NPI) | 1568730091 |
Entity Type | Individual |
Full Name | DR. JORDAN LYNN BRAZEAL |
Credential | PHARM.D. |
Practice Address |
4010 S Mulberry St Pine Bluff AR 71603-7000 |
Practice Telephone | 8705416044 |
Practice Fax Number | 8705417601 |
Mailing Telephone | 8705416044 |
Mailing Fax Number | 8705417601 |
Enumeration Date | 2011-12-12 |
Last Update Date | 2014-01-17 |
Gender Code | M |
Is Sole Proprietor | Y |
Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
---|---|---|---|---|---|
Y | 183500000X | Pharmacist | PD11871 | AR | Pharmacy Service Providers |
Street Address |
4010 S MULBERRY ST |
City | PINE BLUFF |
State | AR |
Zip Code | 71603-7000 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1700842218 | Darrell R Over | Family Medicine | 4010 S Mulberry St, Pine Bluff, AR 71603-7000 | 2006-04-24 |
1912492943 | Michael Falaye | Student in an Organized Health Care Education/Training Program | 4010 S Mulberry St, Pine Bluff, AR 71603-7000 | 2018-06-22 |
1720575822 | Vinian R Richards | Student in an Organized Health Care Education/Training Program | 4010 S Mulberry St, Pine Bluff, AR 71603-7000 | 2018-04-16 |
1265939342 | Michael May | Student in an Organized Health Care Education/Training Program | 4010 S Mulberry St, Pine Bluff, AR 71603-7000 | 2018-04-06 |
1922505080 | Abdulmattaleb Al Soufi | Student in an Organized Health Care Education/Training Program | 4010 S Mulberry St, Pine Bluff, AR 71603-7000 | 2018-04-06 |
1811494974 | Jheanelle Dawkins | Family Medicine | 4010 S Mulberry St, Pine Bluff, AR 71603-7000 | 2018-04-06 |
1336646496 | Robert Ferguson | Student in an Organized Health Care Education/Training Program | 4010 S Mulberry St, Pine Bluff, AR 71603-7000 | 2018-04-06 |
1841797933 | Gireesh Sadasivan | Student in an Organized Health Care Education/Training Program | 4010 S Mulberry St, Pine Bluff, AR 71603-7000 | 2018-04-06 |
1326545401 | Todd Firmatura | Student in an Organized Health Care Education/Training Program | 4010 S Mulberry St, Pine Bluff, AR 71603-7000 | 2018-04-06 |
1043745508 | Samuel Henderson | Family Medicine | 4010 S Mulberry St, Pine Bluff, AR 71603-7000 | 2017-04-21 |
Find all providers in the same location |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1700445038 | Hannah Carter | Dentist | 3801 S Olive St, Pine Bluff, AR 71603 | 2019-06-11 |
1821544628 | Nauman Yunus Md Pa | Internal Medicine | 1600 West 40th Ave, Jefferson Regional Medical Center, Pine Bluff, AR 71603 | 2016-08-31 |
1407278120 | Arkansas Cancer Clinic Pa | Radiology | 7200 South Hazel Street, Pine Bluff, AR 71603 | 2014-01-15 |
1730515396 | Sharon Yvette Webb | Student in an Organized Health Care Education/Training Program | 2318 Kyle Street, Pine Bluff, AR 71603 | 2013-09-16 |
1477992733 | David Larry Byrd | Pharmacist | 5 Longmeadow, Pine Bluff, AR 71603 | 2013-06-20 |
1437400371 | Thomas Jordan Harper | Pharmacist | 2809 South Camden Road, Pine Bluff, AR 71603 | 2012-10-01 |
1992080469 | C&d Disability.inc | Early Intervention Provider Agency | 4806 W 9th Street, Pine Bluff, AR 71603 | 2011-10-17 |
1457645863 | Clifton G Roaf & Marvin Q Caudle | Dentist | 1310 South Linden Street, Pine Bluff, AR 71603 | 2011-06-02 |
1932402682 | Mary Campbell | Licensed Practical Nurse | 2302 W. 28th, Suite A, Pine Bluff, AR 71603 | 2010-12-17 |
1245468925 | Evan N Newbolt | Ophthalmology | 3805 West 28th Ave, Pine Bluff, AR 71603 | 2009-07-01 |
Find all providers in zip 71603 |
Taxonomy Code | 183500000X |
Grouping | Pharmacy Service Providers |
Classification | Pharmacist |
An individual licensed by the appropriate state regulatory agency to engage in the practice of pharmacy. The practice of pharmacy includes, but is not limited to, assessment, interpretation, evaluation, and implementation, initiation, monitoring or modification of medication and or medical orders; the compounding or dispensing of medication and or medical orders; participation in drug and device procurement, storage, and selection; drug administration; drug regimen reviews; drug or drug-related research; provision of patient education and the provision of those acts or services necessary to provide medication therapy management services in all areas of patient care. |
Notes: Source: Adapted from National Association of Boards of Pharmacy Model State Pharmacy Act, Article 1, Section 104. [1/1/2006: definition modified, source modified] |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1265929087 | Flowers Pharmacy LLC | Pharmacist | 1401 State Street, Suite A, Pine Bluff, AR 71601-5856 | 2018-04-17 |
1447680459 | Charles Robert Stimson | Pharmacist | 2809 S Camden Rd, Pine Bluff, AR 71603-4628 | 2013-11-13 |
1477992733 | David Larry Byrd | Pharmacist | 5 Longmeadow, Pine Bluff, AR 71603 | 2013-06-20 |
1437400371 | Thomas Jordan Harper | Pharmacist | 2809 South Camden Road, Pine Bluff, AR 71603 | 2012-10-01 |
1437298213 | Flowers Pharmacy | Pharmacist | 1401 State Street Ste A, Pine Bluff, AR 71601-5856 | 2007-02-06 |
1609480185 | Humphrey Tayong Tekum | Pharmacist | 2503 W 28th Ave, Pine Bluff, AR 71603-5053 | 2020-09-02 |
1730792623 | Yasheika Ania | Pharmacist | 2503 W 28th Ave, Pine Bluff, AR 71603-5053 | 2020-08-28 |
1063043339 | Lindsay E Smart | Pharmacist | 5805 Dollarway Rd, Pine Bluff, AR 71602-3824 | 2020-01-27 |
1104456367 | Christopher Ray Howard | Pharmacist | 5805 Dollarway Rd, Pine Bluff, AR 71602-3824 | 2020-01-16 |
1043857394 | Tiffany Daniel | Pharmacist | 1605 E Harding Ave, Pine Bluff, AR 71601-6823 | 2019-12-05 |
Find all providers in PINE BLUFF |
City | PINE BLUFF |
Zip Code | 71603 |
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Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.