Provider Demographics
NPI:1326067984
Name:WILSON, AMY S (RPH,PHARMD)
Entity Type:Individual
Prefix:DR
First Name:AMY
Middle Name:S
Last Name:WILSON
Suffix:
Gender:F
Credentials:RPH,PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3400 LEBANON RD # 119
Mailing Address - Street 2:
Mailing Address - City:MURFREESBORO
Mailing Address - State:TN
Mailing Address - Zip Code:37129-1392
Mailing Address - Country:US
Mailing Address - Phone:615-225-3376
Mailing Address - Fax:
Practice Address - Street 1:3400 LEBANON PIKE
Practice Address - Street 2:PHARMACY SERVICE 119
Practice Address - City:MURFREESBORO
Practice Address - State:TN
Practice Address - Zip Code:37129
Practice Address - Country:US
Practice Address - Phone:615-225-4737
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-07-18
Last Update Date:2024-03-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN112441835P0018X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1835P0018XPharmacy Service ProvidersPharmacistPharmacist Clinician (PhC)/ Clinical Pharmacy Specialist