Provider Demographics
NPI:1275854408
Name:ROSA, AMY ADAMS (PHARMD)
Entity Type:Individual
Prefix:DR
First Name:AMY
Middle Name:ADAMS
Last Name:ROSA
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 1:12811 LILY POND LN
Mailing Address - Street 2:
Mailing Address - City:KNOXVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37922-6601
Mailing Address - Country:US
Mailing Address - Phone:919-360-5096
Mailing Address - Fax:
Practice Address - Street 1:12811 LILY POND LN
Practice Address - Street 2:
Practice Address - City:KNOXVILLE
Practice Address - State:TN
Practice Address - Zip Code:37922-6601
Practice Address - Country:US
Practice Address - Phone:919-360-5096
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-06-22
Last Update Date:2010-06-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN32953183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist