Provider Demographics
NPI:1205453214
Name:VOLNER, AUTUMN (PHARMD)
Entity type:Individual
Prefix:
First Name:AUTUMN
Middle Name:
Last Name:VOLNER
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 1:105 CHICKASAW RIDGE DR
Mailing Address - Street 2:
Mailing Address - City:OAKLAND
Mailing Address - State:TN
Mailing Address - Zip Code:38060-6206
Mailing Address - Country:US
Mailing Address - Phone:901-465-0466
Mailing Address - Fax:
Practice Address - Street 1:105 CHICKASAW RIDGE DR
Practice Address - Street 2:
Practice Address - City:OAKLAND
Practice Address - State:TN
Practice Address - Zip Code:38060-6206
Practice Address - Country:US
Practice Address - Phone:901-465-0466
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-06-26
Last Update Date:2021-03-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN44236183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist