Provider Demographics
NPI:1073973814
Name:SIMMONS, CHERYL LYNN (RPH)
Entity Type:Individual
Prefix:
First Name:CHERYL
Middle Name:LYNN
Last Name:SIMMONS
Suffix:
Gender:F
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2551 WHITFIELD RD
Mailing Address - Street 2:
Mailing Address - City:CLARKSVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37040-7500
Mailing Address - Country:US
Mailing Address - Phone:931-436-9564
Mailing Address - Fax:931-436-9564
Practice Address - Street 1:2551 WHITFIELD RD
Practice Address - Street 2:
Practice Address - City:CLARKSVILLE
Practice Address - State:TN
Practice Address - Zip Code:37040-7500
Practice Address - Country:US
Practice Address - Phone:931-436-9564
Practice Address - Fax:931-436-9564
Is Sole Proprietor?:No
Enumeration Date:2016-03-04
Last Update Date:2016-03-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN8320183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist