Provider Demographics
NPI:1134616725
Name:MALLINI, BRITTANY CRAWFORD (PHARMD)
Entity type:Individual
Prefix:
First Name:BRITTANY
Middle Name:CRAWFORD
Last Name:MALLINI
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:
Other - First Name:BRITTANY
Other - Middle Name:CANDICE
Other - Last Name:CRAWFORD
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PHARMD
Mailing Address - Street 1:568 N BLACK CREEK RD
Mailing Address - Street 2:
Mailing Address - City:SUMRALL
Mailing Address - State:MS
Mailing Address - Zip Code:39482-3971
Mailing Address - Country:US
Mailing Address - Phone:662-419-5546
Mailing Address - Fax:
Practice Address - Street 1:6051 U S HIGHWAY 49
Practice Address - Street 2:
Practice Address - City:HATTIESBURG
Practice Address - State:MS
Practice Address - Zip Code:39401-7200
Practice Address - Country:US
Practice Address - Phone:662-419-5546
Practice Address - Fax:601-288-4163
Is Sole Proprietor?:No
Enumeration Date:2018-04-18
Last Update Date:2018-04-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MSE-0104301835P0018X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1835P0018XPharmacy Service ProvidersPharmacistPharmacist Clinician (PhC)/ Clinical Pharmacy Specialist