MEDICARE: MRS. JILLIAN KELSEY BROWN PHARMD

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	42440	TN

General Provider Information

NPI Number	:	1710513775
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. JILLIAN KELSEY BROWN PHARMD

Provider Business Mailing Address
First Line	:	620 AUTRY RIDGE LN
Second Line	:
City	:	KNOXVILLE
State	:	TN
Zip	:	37934-4458
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	570 HIGHWAY 321 N
Second Line	:
City	:	LENOIR CITY
State	:	TN
Zip	:	37771-6545
Country	:	US
Telephone Number	:	865-986-6563
Fax Number	:

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

Provider Enumeration Date	:	03/20/2020
Last Update Date	:	03/20/2020

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