Provider Demographics
NPI:1952614406
Name:BECKMAN, SHANNON WOODS (PHARM D)
Entity Type:Individual
Prefix:
First Name:SHANNON
Middle Name:WOODS
Last Name:BECKMAN
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 1:5350 MIDDLEBURY DR
Mailing Address - Street 2:
Mailing Address - City:MURFREESBORO
Mailing Address - State:TN
Mailing Address - Zip Code:37128-2752
Mailing Address - Country:US
Mailing Address - Phone:615-427-2190
Mailing Address - Fax:
Practice Address - Street 1:1801 MEMORIAL BLVD
Practice Address - Street 2:
Practice Address - City:MURFREESBORO
Practice Address - State:TN
Practice Address - Zip Code:37129-1522
Practice Address - Country:US
Practice Address - Phone:615-896-5731
Practice Address - Fax:615-278-2812
Is Sole Proprietor?:No
Enumeration Date:2010-07-26
Last Update Date:2010-07-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN34401183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist