Provider Demographics
NPI:1710228903
Name:JUE, PATRICIA (PHARMD)
Entity Type:Individual
Prefix:
First Name:PATRICIA
Middle Name:
Last Name:JUE
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 1:9025 HIGHWAY 64
Mailing Address - Street 2:
Mailing Address - City:LAKELAND
Mailing Address - State:TN
Mailing Address - Zip Code:38002-8448
Mailing Address - Country:US
Mailing Address - Phone:901-383-2265
Mailing Address - Fax:
Practice Address - Street 1:9025 HIGHWAY 64
Practice Address - Street 2:
Practice Address - City:LAKELAND
Practice Address - State:TN
Practice Address - Zip Code:38002-8448
Practice Address - Country:US
Practice Address - Phone:901-383-2265
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-03-13
Last Update Date:2013-03-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN150183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist