Provider Demographics
NPI:1710299987
Name:WANNER, ERIN JANELLE (PHARMD)
Entity Type:Individual
Prefix:DR
First Name:ERIN
Middle Name:JANELLE
Last Name:WANNER
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:DR
Other - First Name:ERIN
Other - Middle Name:JANELLE
Other - Last Name:WANNER
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:RPH
Mailing Address - Street 1:3400 JENKINS RD APT 624
Mailing Address - Street 2:
Mailing Address - City:CHATTANOOGA
Mailing Address - State:TN
Mailing Address - Zip Code:37421-1162
Mailing Address - Country:US
Mailing Address - Phone:865-384-6546
Mailing Address - Fax:
Practice Address - Street 1:35 25TH ST NW
Practice Address - Street 2:
Practice Address - City:CLEVELAND
Practice Address - State:TN
Practice Address - Zip Code:37311-3830
Practice Address - Country:US
Practice Address - Phone:423-614-4810
Practice Address - Fax:423-614-5397
Is Sole Proprietor?:No
Enumeration Date:2010-07-05
Last Update Date:2010-07-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN67417191835P1200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1835P1200XPharmacy Service ProvidersPharmacistPharmacotherapy