Provider Demographics
NPI:1710339486
Name:ROYAL, ELIZABETH ELISHA (PHARMD)
Entity Type:Individual
Prefix:DR
First Name:ELIZABETH
Middle Name:ELISHA
Last Name:ROYAL
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 1:512 FERNWOOD DR
Mailing Address - Street 2:
Mailing Address - City:KINGSPORT
Mailing Address - State:TN
Mailing Address - Zip Code:37663-2006
Mailing Address - Country:US
Mailing Address - Phone:423-956-7845
Mailing Address - Fax:
Practice Address - Street 1:2021 N BROADWAY ST
Practice Address - Street 2:
Practice Address - City:KNOXVILLE
Practice Address - State:TN
Practice Address - Zip Code:37917-5808
Practice Address - Country:US
Practice Address - Phone:865-525-4189
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-07-06
Last Update Date:2016-07-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN40208183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist