MEDICARE: MRS. SHELBY LEIGH LANHAM

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	183500000X	Pharmacist	023367	KY
2	183500000X	Pharmacist	46974	TN

General Provider Information

NPI Number	:	1306411152
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. SHELBY LEIGH LANHAM

Provider Business Mailing Address
First Line	:	1672 ROBIN PL
Second Line	:
City	:	CLARKSVILLE
State	:	TN
Zip	:	37043-5151
Country	:	US
Telephone Number	:	615-598-5935
Fax Number	:

Provider Business Practice Location Address
First Line	:	2015 NEEDMORE RD
Second Line	:
City	:	CLARKSVILLE
State	:	TN
Zip	:	37042-4503
Country	:	US
Telephone Number	:	931-919-0095
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	05/24/2021
Last Update Date	:	05/11/2026

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