Provider Demographics
NPI:1942714688
Name:HUSKEY, RENEE MIKLYN (PHARMD)
Entity Type:Individual
Prefix:DR
First Name:RENEE
Middle Name:MIKLYN
Last Name:HUSKEY
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 1:149 COUNTY ROAD 650
Mailing Address - Street 2:
Mailing Address - City:ETOWAH
Mailing Address - State:TN
Mailing Address - Zip Code:37331-5322
Mailing Address - Country:US
Mailing Address - Phone:423-368-6439
Mailing Address - Fax:
Practice Address - Street 1:1001 W MADISON AVE
Practice Address - Street 2:
Practice Address - City:ATHENS
Practice Address - State:TN
Practice Address - Zip Code:37303-3433
Practice Address - Country:US
Practice Address - Phone:423-746-2626
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-11-16
Last Update Date:2020-04-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN41440183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist