Provider Demographics
NPI:1629373824
Name:MITCHELL, TAMARA JONEE (PHARMD)
Entity Type:Individual
Prefix:
First Name:TAMARA
Middle Name:JONEE
Last Name:MITCHELL
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 1:8217 US HIGHWAY 51 N
Mailing Address - Street 2:
Mailing Address - City:MILLINGTON
Mailing Address - State:TN
Mailing Address - Zip Code:38053-1707
Mailing Address - Country:US
Mailing Address - Phone:901-872-3223
Mailing Address - Fax:901-872-3230
Practice Address - Street 1:8217 US HIGHWAY 51 N
Practice Address - Street 2:
Practice Address - City:MILLINGTON
Practice Address - State:TN
Practice Address - Zip Code:38053-1707
Practice Address - Country:US
Practice Address - Phone:901-872-3223
Practice Address - Fax:901-872-3230
Is Sole Proprietor?:No
Enumeration Date:2011-01-19
Last Update Date:2011-01-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN0000033069183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist