Provider Demographics
NPI:1336438985
Name:HURLEY, RALLIE DEANN (PHARMD)
Entity Type:Individual
Prefix:DR
First Name:RALLIE
Middle Name:DEANN
Last Name:HURLEY
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 1:1921 HIGHWAY 394
Mailing Address - Street 2:
Mailing Address - City:BLOUNTVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37617-5454
Mailing Address - Country:US
Mailing Address - Phone:423-323-3312
Mailing Address - Fax:
Practice Address - Street 1:500 FOREST DR
Practice Address - Street 2:
Practice Address - City:JONESBOROUGH
Practice Address - State:TN
Practice Address - Zip Code:37659-1510
Practice Address - Country:US
Practice Address - Phone:423-753-3468
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-04-05
Last Update Date:2021-01-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN0000023969183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist