Provider Demographics
NPI:1700473097
Name:FAULKNER, TRICIA CAMILLE (PHARM D)
Entity Type:Individual
Prefix:
First Name:TRICIA
Middle Name:CAMILLE
Last Name:FAULKNER
Suffix:
Gender:F
Credentials:PHARM D
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1901 HILLSIDE AVE
Mailing Address - Street 2:
Mailing Address - City:NASHVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37203-5438
Mailing Address - Country:US
Mailing Address - Phone:615-692-8794
Mailing Address - Fax:
Practice Address - Street 1:4805 COLUMBIA PIKE
Practice Address - Street 2:
Practice Address - City:THOMPSONS STATION
Practice Address - State:TN
Practice Address - Zip Code:37179-5207
Practice Address - Country:US
Practice Address - Phone:615-791-0974
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-12-21
Last Update Date:2020-12-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN253411835P2201X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1835P2201XPharmacy Service ProvidersPharmacistAmbulatory Care