Provider Demographics
NPI:1902182413
Name:SIELAFF, MICHELLE LEANNE (PHARMD)
Entity Type:Individual
Prefix:
First Name:MICHELLE
Middle Name:LEANNE
Last Name:SIELAFF
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 1:2421 LEBANON PIKE
Mailing Address - Street 2:
Mailing Address - City:NASHVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37214-2412
Mailing Address - Country:US
Mailing Address - Phone:615-885-4480
Mailing Address - Fax:
Practice Address - Street 1:2421 LEBANON PIKE
Practice Address - Street 2:
Practice Address - City:NASHVILLE
Practice Address - State:TN
Practice Address - Zip Code:37214-2412
Practice Address - Country:US
Practice Address - Phone:615-885-4480
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-10-28
Last Update Date:2013-04-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN27715183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist