Provider Demographics
NPI:1497521579
Name:BELKOUER, IVANA
Entity Type:Individual
Prefix:
First Name:IVANA
Middle Name:
Last Name:BELKOUER
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7113 CHARLOTTE PIKE APT 569
Mailing Address - Street 2:
Mailing Address - City:NASHVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37209-5324
Mailing Address - Country:US
Mailing Address - Phone:678-760-3226
Mailing Address - Fax:
Practice Address - Street 1:7113 CHARLOTTE PIKE APT 569
Practice Address - Street 2:
Practice Address - City:NASHVILLE
Practice Address - State:TN
Practice Address - Zip Code:37209-5324
Practice Address - Country:US
Practice Address - Phone:678-760-3226
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-11-29
Last Update Date:2023-11-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN474141835P0018X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1835P0018XPharmacy Service ProvidersPharmacistPharmacist Clinician (PhC)/ Clinical Pharmacy Specialist