Jessica Broyles
Individual provider Active NPI Pharmacist · Greeneville, TN
NPI 1669726261 · NPPES record last updated Nov 4, 2012
Key facts
- NPI
- 1669726261
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Pharmacist 183500000X
- License
- 0000029427 (TN)
- Practice address
- 1355 Tusculum Blvd
Greeneville, TN 37745-4249 - Phone
- (423) 636-1344
- Fax
- (423) 636-8951
- NPI assigned
- Nov 4, 2012
- Sex
- Female
- Sole proprietor
- Yes
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 0000029427 | TN | MD | Pharmacist |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pharmacist | 183500000X | 0000029427 | TN | Yes |
Addresses
Primary practice location
1355 Tusculum Blvd
Greeneville, TN 37745-4249
Mailing address
1355 Tusculum Blvd
Greeneville, TN 37745-4249
Phone (423) 636-1344
Other providers in Greeneville, TN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Nov 4, 2012. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.