Provider Demographics
NPI:1407149248
Name:THARP, SHANNON LEE (PHARMD)
Entity Type:Individual
Prefix:
First Name:SHANNON
Middle Name:LEE
Last Name:THARP
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 1:1010 GLENBROOK WAY
Mailing Address - Street 2:
Mailing Address - City:HENDERSONVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37075-1230
Mailing Address - Country:US
Mailing Address - Phone:615-822-1138
Mailing Address - Fax:
Practice Address - Street 1:1010 GLENBROOK WAY
Practice Address - Street 2:
Practice Address - City:HENDERSONVILLE
Practice Address - State:TN
Practice Address - Zip Code:37075-1230
Practice Address - Country:US
Practice Address - Phone:615-822-1138
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-05-26
Last Update Date:2020-10-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN8741183500000X
WA227900000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist
No227900000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersRespiratory Therapist, Registered