Provider Demographics
NPI:1477838803
Name:WATTENBARGER, ANNA CATHERINE (PHARMD)
Entity Type:Individual
Prefix:
First Name:ANNA
Middle Name:CATHERINE
Last Name:WATTENBARGER
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 1:11847 KINGSTON PIKE
Mailing Address - Street 2:
Mailing Address - City:FARRAGUT
Mailing Address - State:TN
Mailing Address - Zip Code:37934-3833
Mailing Address - Country:US
Mailing Address - Phone:865-777-2469
Mailing Address - Fax:865-777-2470
Practice Address - Street 1:11847 KINGSTON PIKE
Practice Address - Street 2:
Practice Address - City:FARRAGUT
Practice Address - State:TN
Practice Address - Zip Code:37934-3833
Practice Address - Country:US
Practice Address - Phone:865-777-2469
Practice Address - Fax:865-777-2470
Is Sole Proprietor?:No
Enumeration Date:2011-10-17
Last Update Date:2017-01-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN11678183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist