Provider Demographics
NPI:1952063141
Name:BRAY, HANNAH MARISSA (PHARMD)
Entity type:Individual
Prefix:
First Name:HANNAH
Middle Name:MARISSA
Last Name:BRAY
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 1:8324 DAY VALLEY RD
Mailing Address - Street 2:
Mailing Address - City:POWELL
Mailing Address - State:TN
Mailing Address - Zip Code:37849-3663
Mailing Address - Country:US
Mailing Address - Phone:423-912-6163
Mailing Address - Fax:
Practice Address - Street 1:310 E CENTRAL AVE
Practice Address - Street 2:
Practice Address - City:LA FOLLETTE
Practice Address - State:TN
Practice Address - Zip Code:37766-3665
Practice Address - Country:US
Practice Address - Phone:423-562-4928
Practice Address - Fax:423-437-8348
Is Sole Proprietor?:No
Enumeration Date:2021-10-06
Last Update Date:2023-10-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN44330183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist