Provider Demographics
NPI:1770895682
Name:WOLFE, LESLIE SHEPARD (PHARMD)
Entity type:Individual
Prefix:DR
First Name:LESLIE
Middle Name:SHEPARD
Last Name:WOLFE
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 1:104 HIGHWAY 70 E
Mailing Address - Street 2:
Mailing Address - City:DICKSON
Mailing Address - State:TN
Mailing Address - Zip Code:37055-2034
Mailing Address - Country:US
Mailing Address - Phone:615-446-5585
Mailing Address - Fax:615-446-7770
Practice Address - Street 1:104 HIGHWAY 70 E
Practice Address - Street 2:
Practice Address - City:DICKSON
Practice Address - State:TN
Practice Address - Zip Code:37055-2034
Practice Address - Country:US
Practice Address - Phone:615-446-5585
Practice Address - Fax:615-446-7770
Is Sole Proprietor?:No
Enumeration Date:2010-07-08
Last Update Date:2021-01-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN34286183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist