Provider Demographics
NPI:1700388741
Name:KERLEY, LINDA ELROD (RPH)
Entity Type:Individual
Prefix:MRS
First Name:LINDA
Middle Name:ELROD
Last Name:KERLEY
Suffix:
Gender:F
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2915 W MARKET ST
Mailing Address - Street 2:
Mailing Address - City:JOHNSON CITY
Mailing Address - State:TN
Mailing Address - Zip Code:37604-9086
Mailing Address - Country:US
Mailing Address - Phone:423-434-2969
Mailing Address - Fax:
Practice Address - Street 1:2915 W MARKET ST
Practice Address - Street 2:
Practice Address - City:JOHNSON CITY
Practice Address - State:TN
Practice Address - Zip Code:37604-9086
Practice Address - Country:US
Practice Address - Phone:423-434-2969
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-03-06
Last Update Date:2018-03-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN5960183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist