Provider Demographics
NPI:1275741548
Name:FLIPPIN, AMY HERRON (RPH)
Entity Type:Individual
Prefix:
First Name:AMY
Middle Name:HERRON
Last Name:FLIPPIN
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 1:532 CHURCH LN
Mailing Address - Street 2:
Mailing Address - City:CHURCH HILL
Mailing Address - State:TN
Mailing Address - Zip Code:37642-3633
Mailing Address - Country:US
Mailing Address - Phone:423-357-6252
Mailing Address - Fax:
Practice Address - Street 1:125 JUDGE GRESHAM RD
Practice Address - Street 2:
Practice Address - City:JOHNSON CITY
Practice Address - State:TN
Practice Address - Zip Code:37615-6213
Practice Address - Country:US
Practice Address - Phone:423-467-0024
Practice Address - Fax:423-467-4215
Is Sole Proprietor?:No
Enumeration Date:2007-05-19
Last Update Date:2008-10-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN11987183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist