Provider Demographics
NPI:1376385930
Name:LOKEN, AMY LEIGH (PHARMD, BCPS)
Entity type:Individual
Prefix:
First Name:AMY
Middle Name:LEIGH
Last Name:LOKEN
Suffix:
Gender:F
Credentials:PHARMD, BCPS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2101 PETERS CREEK PKWY STE 16-19
Mailing Address - Street 2:
Mailing Address - City:WINSTON SALEM
Mailing Address - State:NC
Mailing Address - Zip Code:27127-3726
Mailing Address - Country:US
Mailing Address - Phone:743-219-1143
Mailing Address - Fax:
Practice Address - Street 1:2101 PETERS CREEK PKWY STE 16-19
Practice Address - Street 2:
Practice Address - City:WINSTON SALEM
Practice Address - State:NC
Practice Address - Zip Code:27127-3726
Practice Address - Country:US
Practice Address - Phone:743-219-1143
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-06-12
Last Update Date:2024-06-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC17967183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist