Provider Demographics
NPI:1922319193
Name:VANCE, ASHLEY ELIZABETH (PHARMD)
Entity Type:Individual
Prefix:DR
First Name:ASHLEY
Middle Name:ELIZABETH
Last Name:VANCE
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:DR
Other - First Name:ASHLEY
Other - Middle Name:ELIZABETH
Other - Last Name:VANCE-JENSEN
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:PHARMD
Mailing Address - Street 1:1210 SMITHVILLE HWY
Mailing Address - Street 2:
Mailing Address - City:MCMINNVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37110-1678
Mailing Address - Country:US
Mailing Address - Phone:931-473-3778
Mailing Address - Fax:931-473-3790
Practice Address - Street 1:1210 SMITHVILLE HWY
Practice Address - Street 2:
Practice Address - City:MCMINNVILLE
Practice Address - State:TN
Practice Address - Zip Code:37110-1678
Practice Address - Country:US
Practice Address - Phone:931-473-3778
Practice Address - Fax:931-473-3790
Is Sole Proprietor?:Yes
Enumeration Date:2010-06-23
Last Update Date:2010-06-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN25060183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist