Provider Demographics
NPI:1598225039
Name:SELLERS, WENDY JANE
Entity Type:Individual
Prefix:MRS
First Name:WENDY
Middle Name:JANE
Last Name:SELLERS
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 1:4300 NEW GETWELL RD
Mailing Address - Street 2:
Mailing Address - City:MEMPHIS
Mailing Address - State:TN
Mailing Address - Zip Code:38118
Mailing Address - Country:US
Mailing Address - Phone:901-482-1980
Mailing Address - Fax:901-284-0084
Practice Address - Street 1:4300 NEW GETWELL RD
Practice Address - Street 2:
Practice Address - City:MEMPHIS
Practice Address - State:TN
Practice Address - Zip Code:38118
Practice Address - Country:US
Practice Address - Phone:901-482-1980
Practice Address - Fax:901-284-0084
Is Sole Proprietor?:No
Enumeration Date:2019-03-21
Last Update Date:2019-03-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MSE-08466183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist