Healthcare Provider Details

I. General information

NPI: 1487396180
Provider Name (Legal Business Name): HADEEL ALTAYAR PHARM D
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/12/2022
Last Update Date: 04/12/2022
Certification Date: 04/12/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6690 NOLENSVILLE RD
BRENTWOOD TN
37027-8803
US

IV. Provider business mailing address

6690 NOLENSVILLE RD
BRENTWOOD TN
37027-8803
US

V. Phone/Fax

Practice location:
  • Phone: 615-941-7640
  • Fax:
Mailing address:
  • Phone: 615-941-7640
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1835P0018X
TaxonomyPharmacist Clinician (PhC)/ Clinical Pharmacy Specialist
License Number41847
License Number StateTN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: