Provider Demographics
NPI:1841545126
Name:ERXLEBEN, VICTORIA ELLEN (PHARMD)
Entity type:Individual
Prefix:DR
First Name:VICTORIA
Middle Name:ELLEN
Last Name:ERXLEBEN
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 1:865 BELLEVUE RD APT B10
Mailing Address - Street 2:
Mailing Address - City:NASHVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37221-2757
Mailing Address - Country:US
Mailing Address - Phone:847-903-2067
Mailing Address - Fax:
Practice Address - Street 1:5200 MARYLAND WAY
Practice Address - Street 2:SUITE 200
Practice Address - City:BRENTWOOD
Practice Address - State:TN
Practice Address - Zip Code:37027-5018
Practice Address - Country:US
Practice Address - Phone:615-312-7047
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-07-23
Last Update Date:2012-07-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA21557183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist