Provider Demographics
NPI:1811590938
Name:SWEAT, CHANQUILLA STEPHANIE (PHARMD, MHA)
Entity Type:Individual
Prefix:DR
First Name:CHANQUILLA
Middle Name:STEPHANIE
Last Name:SWEAT
Suffix:
Gender:F
Credentials:PHARMD, MHA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3873 NORTHBROOK DR
Mailing Address - Street 2:
Mailing Address - City:NASHVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37207-1785
Mailing Address - Country:US
Mailing Address - Phone:615-481-5416
Mailing Address - Fax:
Practice Address - Street 1:780 OLD HICKORY BLVD
Practice Address - Street 2:
Practice Address - City:BRENTWOOD
Practice Address - State:TN
Practice Address - Zip Code:37027-4527
Practice Address - Country:US
Practice Address - Phone:615-238-0127
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-11-20
Last Update Date:2020-11-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN44079183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist