Provider Demographics
NPI:1396853545
Name:HALSELL, GINGER LAVENA (PHARMD)
Entity Type:Individual
Prefix:MRS
First Name:GINGER
Middle Name:LAVENA
Last Name:HALSELL
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 1:250 PAT CARR LN
Mailing Address - Street 2:
Mailing Address - City:ALPINE
Mailing Address - State:TN
Mailing Address - Zip Code:38543-6172
Mailing Address - Country:US
Mailing Address - Phone:931-646-7551
Mailing Address - Fax:
Practice Address - Street 1:200 W 10TH ST
Practice Address - Street 2:
Practice Address - City:COOKEVILLE
Practice Address - State:TN
Practice Address - Zip Code:38501-6077
Practice Address - Country:US
Practice Address - Phone:931-646-7551
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-08-28
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN9079183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist