Provider Demographics
NPI:1073825899
Name:HARRISON, MONICA (PHARMD)
Entity Type:Individual
Prefix:
First Name:MONICA
Middle Name:
Last Name:HARRISON
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6565 SAINT ELMO RD
Mailing Address - Street 2:
Mailing Address - City:BARTLETT
Mailing Address - State:TN
Mailing Address - Zip Code:38135-9448
Mailing Address - Country:US
Mailing Address - Phone:901-383-1547
Mailing Address - Fax:901-383-2558
Practice Address - Street 1:6565 SAINT ELMO RD
Practice Address - Street 2:
Practice Address - City:BARTLETT
Practice Address - State:TN
Practice Address - Zip Code:38135-9448
Practice Address - Country:US
Practice Address - Phone:901-383-1547
Practice Address - Fax:901-383-2558
Is Sole Proprietor?:Yes
Enumeration Date:2010-07-09
Last Update Date:2010-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN11210183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist