Provider Demographics
NPI:1649654872
Name:HONAKER-JACKSON, MARSHA R (PHARMD)
Entity type:Individual
Prefix:DR
First Name:MARSHA
Middle Name:R
Last Name:HONAKER-JACKSON
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 1:1162 W POPLAR AVE
Mailing Address - Street 2:
Mailing Address - City:COLLIERVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:38017-3196
Mailing Address - Country:US
Mailing Address - Phone:901-316-5752
Mailing Address - Fax:901-316-5760
Practice Address - Street 1:60 MARKET CENTER DR STE 103
Practice Address - Street 2:
Practice Address - City:COLLIERVILLE
Practice Address - State:TN
Practice Address - Zip Code:38017-7077
Practice Address - Country:US
Practice Address - Phone:901-316-5752
Practice Address - Fax:901-316-5760
Is Sole Proprietor?:No
Enumeration Date:2015-07-17
Last Update Date:2015-07-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN110721835P0018X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1835P0018XPharmacy Service ProvidersPharmacistPharmacist Clinician (PhC)/ Clinical Pharmacy Specialist