Provider Demographics
NPI:1093108250
Name:KEESE, JULIE (PHARM D)
Entity Type:Individual
Prefix:
First Name:JULIE
Middle Name:
Last Name:KEESE
Suffix:
Gender:F
Credentials:PHARM D
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:180 RUTLEDGE PIKE
Mailing Address - Street 2:
Mailing Address - City:BLAINE
Mailing Address - State:TN
Mailing Address - Zip Code:37709-2416
Mailing Address - Country:US
Mailing Address - Phone:865-933-0762
Mailing Address - Fax:865-932-1704
Practice Address - Street 1:180 RUTLEDGE PIKE
Practice Address - Street 2:
Practice Address - City:BLAINE
Practice Address - State:TN
Practice Address - Zip Code:37709-2416
Practice Address - Country:US
Practice Address - Phone:865-933-0762
Practice Address - Fax:865-932-1704
Is Sole Proprietor?:Yes
Enumeration Date:2015-03-12
Last Update Date:2016-12-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN37731183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist