Provider Demographics
NPI:1124909080
Name:O'NEAL, TAKIRRYA KRISHEA
Entity type:Individual
Prefix:
First Name:TAKIRRYA
Middle Name:KRISHEA
Last Name:O'NEAL
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3501 PEACHTREE DR
Mailing Address - Street 2:
Mailing Address - City:NATCHEZ
Mailing Address - State:MS
Mailing Address - Zip Code:39120-4109
Mailing Address - Country:US
Mailing Address - Phone:318-240-7149
Mailing Address - Fax:
Practice Address - Street 1:236 S MAIN ST
Practice Address - Street 2:
Practice Address - City:MARKSVILLE
Practice Address - State:LA
Practice Address - Zip Code:71351-3052
Practice Address - Country:US
Practice Address - Phone:318-240-7149
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-09-09
Last Update Date:2025-09-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA025939183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist