Provider Demographics
NPI:1083113526
Name:DUEA, CHRISSA (RPH)
Entity Type:Individual
Prefix:
First Name:CHRISSA
Middle Name:
Last Name:DUEA
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 1:3755 E ANDREW JOHNSON HWY
Mailing Address - Street 2:
Mailing Address - City:GREENEVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37745-1084
Mailing Address - Country:US
Mailing Address - Phone:423-639-7139
Mailing Address - Fax:423-639-0034
Practice Address - Street 1:3755 E ANDREW JOHNSON HWY
Practice Address - Street 2:
Practice Address - City:GREENEVILLE
Practice Address - State:TN
Practice Address - Zip Code:37745-1084
Practice Address - Country:US
Practice Address - Phone:423-639-7139
Practice Address - Fax:423-639-0034
Is Sole Proprietor?:No
Enumeration Date:2018-02-11
Last Update Date:2018-02-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN8803183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist