Provider Demographics
NPI:1770167702
Name:BARE, LAUREN ASHLEY (PHARMD)
Entity type:Individual
Prefix:DR
First Name:LAUREN
Middle Name:ASHLEY
Last Name:BARE
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 1:113 SOUTHAMPTON CT
Mailing Address - Street 2:
Mailing Address - City:GOODLETTSVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37072-2134
Mailing Address - Country:US
Mailing Address - Phone:615-766-0771
Mailing Address - Fax:
Practice Address - Street 1:510 TN-76 E
Practice Address - Street 2:
Practice Address - City:WHITE HOUSE
Practice Address - State:TN
Practice Address - Zip Code:37188
Practice Address - Country:US
Practice Address - Phone:615-672-3905
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-05-06
Last Update Date:2021-05-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN44442183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist