Provider Demographics
NPI:1881293678
Name:BILLINGSLY, TINA (PHARMD)
Entity type:Individual
Prefix:DR
First Name:TINA
Middle Name:
Last Name:BILLINGSLY
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 1:4091 BILLINGSLY RD
Mailing Address - Street 2:
Mailing Address - City:GREENWOOD
Mailing Address - State:IN
Mailing Address - Zip Code:46143-9717
Mailing Address - Country:US
Mailing Address - Phone:317-888-7252
Mailing Address - Fax:
Practice Address - Street 1:2125 N MORTON ST
Practice Address - Street 2:
Practice Address - City:FRANKLIN
Practice Address - State:IN
Practice Address - Zip Code:46131-9624
Practice Address - Country:US
Practice Address - Phone:317-738-4387
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-10-22
Last Update Date:2020-10-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN26020792A183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist