Provider Demographics
NPI:1952955783
Name:TUTWILER, CHARNESA (PHARMD)
Entity type:Individual
Prefix:
First Name:CHARNESA
Middle Name:
Last Name:TUTWILER
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 1:7509 EASTERLY LN
Mailing Address - Street 2:
Mailing Address - City:MEMPHIS
Mailing Address - State:TN
Mailing Address - Zip Code:38125-4316
Mailing Address - Country:US
Mailing Address - Phone:901-326-3923
Mailing Address - Fax:
Practice Address - Street 1:1863 UNION AVE
Practice Address - Street 2:
Practice Address - City:MEMPHIS
Practice Address - State:TN
Practice Address - Zip Code:38104-4028
Practice Address - Country:US
Practice Address - Phone:901-272-2006
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-07-30
Last Update Date:2019-07-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN43404183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist