Provider Demographics
NPI:1841377652
Name:HOPE, SHAWN LEE (DPH)
Entity type:Individual
Prefix:MS
First Name:SHAWN
Middle Name:LEE
Last Name:HOPE
Suffix:
Gender:F
Credentials:DPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5730 SNAPPS FERRY RD
Mailing Address - Street 2:
Mailing Address - City:AFTON
Mailing Address - State:TN
Mailing Address - Zip Code:37616-5048
Mailing Address - Country:US
Mailing Address - Phone:423-638-1177
Mailing Address - Fax:
Practice Address - Street 1:1420 TUSCULUM BLVD
Practice Address - Street 2:
Practice Address - City:GREENEVILLE
Practice Address - State:TN
Practice Address - Zip Code:37745-4279
Practice Address - Country:US
Practice Address - Phone:423-787-5065
Practice Address - Fax:423-787-5067
Is Sole Proprietor?:No
Enumeration Date:2006-11-01
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN03805183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist