Provider Demographics
NPI:1720328024
Name:LEONARD, MALARIE BROOKE (PHARMD)
Entity Type:Individual
Prefix:DR
First Name:MALARIE
Middle Name:BROOKE
Last Name:LEONARD
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 1:630 RB WILSON DR
Mailing Address - Street 2:
Mailing Address - City:HUNTINGDON
Mailing Address - State:TN
Mailing Address - Zip Code:38344
Mailing Address - Country:US
Mailing Address - Phone:731-986-2228
Mailing Address - Fax:
Practice Address - Street 1:630 RB WILSON DR
Practice Address - Street 2:
Practice Address - City:HUNTINGDON
Practice Address - State:TN
Practice Address - Zip Code:38344-1726
Practice Address - Country:US
Practice Address - Phone:731-986-2228
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-02-22
Last Update Date:2013-03-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN36592183500000X
MS12529183500000X
AL17135183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist