Provider Demographics
NPI:1275145922
Name:COON, CHELSEA ALEXIS (PHARMD)
Entity Type:Individual
Prefix:DR
First Name:CHELSEA
Middle Name:ALEXIS
Last Name:COON
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 1:3381 POPLAR AVE
Mailing Address - Street 2:
Mailing Address - City:MEMPHIS
Mailing Address - State:TN
Mailing Address - Zip Code:38111-4601
Mailing Address - Country:US
Mailing Address - Phone:901-458-8559
Mailing Address - Fax:901-458-0165
Practice Address - Street 1:3381 POPLAR AVE
Practice Address - Street 2:
Practice Address - City:MEMPHIS
Practice Address - State:TN
Practice Address - Zip Code:38111-4601
Practice Address - Country:US
Practice Address - Phone:901-458-8559
Practice Address - Fax:901-458-0165
Is Sole Proprietor?:No
Enumeration Date:2020-08-22
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN42626183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist