Provider Demographics
NPI:1629353131
Name:GARNER, LACEY RUPE (PHARMD)
Entity Type:Individual
Prefix:DR
First Name:LACEY
Middle Name:RUPE
Last Name:GARNER
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 1:113 SELINAWOOD PL
Mailing Address - Street 2:
Mailing Address - City:FRANKLIN
Mailing Address - State:TN
Mailing Address - Zip Code:37067-5958
Mailing Address - Country:US
Mailing Address - Phone:615-567-6911
Mailing Address - Fax:
Practice Address - Street 1:113 SELINAWOOD PL
Practice Address - Street 2:
Practice Address - City:FRANKLIN
Practice Address - State:TN
Practice Address - Zip Code:37067-5958
Practice Address - Country:US
Practice Address - Phone:615-567-6911
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-10-15
Last Update Date:2011-10-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN33165183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist