Provider Demographics
NPI:1376885855
Name:JIN, MIAO (RPH)
Entity Type:Individual
Prefix:MS
First Name:MIAO
Middle Name:
Last Name:JIN
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 1:850 BATTERY LN
Mailing Address - Street 2:
Mailing Address - City:NASHVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37220-1104
Mailing Address - Country:US
Mailing Address - Phone:615-760-5386
Mailing Address - Fax:
Practice Address - Street 1:850 BATTERY LN
Practice Address - Street 2:
Practice Address - City:NASHVILLE
Practice Address - State:TN
Practice Address - Zip Code:37220-1104
Practice Address - Country:US
Practice Address - Phone:615-760-5386
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-03-21
Last Update Date:2013-03-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI5302032126183500000X
TN36242183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist