Provider Demographics
NPI:1881795359
Name:ANDERSON, SIRIPRAWN JERRIE (PHARM D)
Entity type:Individual
Prefix:MRS
First Name:SIRIPRAWN
Middle Name:JERRIE
Last Name:ANDERSON
Suffix:
Gender:F
Credentials:PHARM D
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2530 GOINGBACK CIR
Mailing Address - Street 2:
Mailing Address - City:SEVIERVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37876-6279
Mailing Address - Country:US
Mailing Address - Phone:865-908-5145
Mailing Address - Fax:
Practice Address - Street 1:229 FORKS OF THE RIVER PKWY
Practice Address - Street 2:
Practice Address - City:SEVIERVILLE
Practice Address - State:TN
Practice Address - Zip Code:37862-3418
Practice Address - Country:US
Practice Address - Phone:865-453-7121
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-09-26
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN00000116581835P1200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1835P1200XPharmacy Service ProvidersPharmacistPharmacotherapy