Provider Demographics
NPI:1568507200
Name:CHAMBERLIN, SHAUNTA' M (PHARMD)
Entity Type:Individual
Prefix:DR
First Name:SHAUNTA'
Middle Name:M
Last Name:CHAMBERLIN
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:DR
Other - First Name:SHAUNTA
Other - Middle Name:D
Other - Last Name:MARTINA
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PHARMD
Mailing Address - Street 1:9907 MARILYN COLLINS WAY
Mailing Address - Street 2:
Mailing Address - City:KNOXVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37931-4290
Mailing Address - Country:US
Mailing Address - Phone:405-706-9100
Mailing Address - Fax:
Practice Address - Street 1:1924 ALCOA HWY # 117
Practice Address - Street 2:
Practice Address - City:KNOXVILLE
Practice Address - State:TN
Practice Address - Zip Code:37920-1511
Practice Address - Country:US
Practice Address - Phone:865-974-2324
Practice Address - Fax:865-974-2022
Is Sole Proprietor?:No
Enumeration Date:2007-02-20
Last Update Date:2019-04-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK13435183500000X
TN28460183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist