Provider Demographics
NPI:1942899828
Name:MCMASTER, SHEILA BROOKE
Entity Type:Individual
Prefix:
First Name:SHEILA
Middle Name:BROOKE
Last Name:MCMASTER
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1463 S HIGHLAND AVE STE A
Mailing Address - Street 2:
Mailing Address - City:JACKSON
Mailing Address - State:TN
Mailing Address - Zip Code:38301-7543
Mailing Address - Country:US
Mailing Address - Phone:173-142-3031
Mailing Address - Fax:731-424-5124
Practice Address - Street 1:1463 S HIGHLAND AVE STE A
Practice Address - Street 2:
Practice Address - City:JACKSON
Practice Address - State:TN
Practice Address - Zip Code:38301-7543
Practice Address - Country:US
Practice Address - Phone:173-142-3031
Practice Address - Fax:731-424-5124
Is Sole Proprietor?:Yes
Enumeration Date:2021-01-14
Last Update Date:2021-01-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN36692183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist