Provider Demographics
NPI:1467886424
Name:CERI, AMANDA MAHALA (PHARMD)
Entity Type:Individual
Prefix:DR
First Name:AMANDA
Middle Name:MAHALA
Last Name:CERI
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:DR
Other - First Name:AMANDA
Other - Middle Name:MAHALA
Other - Last Name:HUSKEY
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PHARMD
Mailing Address - Street 1:1004 ANDREWS RUN
Mailing Address - Street 2:
Mailing Address - City:HENDERSONVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37075-1232
Mailing Address - Country:US
Mailing Address - Phone:615-826-7971
Mailing Address - Fax:
Practice Address - Street 1:1004 ANDREWS RUN
Practice Address - Street 2:
Practice Address - City:HENDERSONVILLE
Practice Address - State:TN
Practice Address - Zip Code:37075-1232
Practice Address - Country:US
Practice Address - Phone:615-826-7971
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-08-27
Last Update Date:2013-08-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN36526183500000X
KY016076183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist