Healthcare Provider Details

I. General information

NPI: 1588006324
Provider Name (Legal Business Name): CATHERINE SHEVLIN MEEKS PHARMD
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/22/2013
Last Update Date: 05/29/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2622 MADISON ST STE A
CLARKSVILLE TN
37043-6549
US

IV. Provider business mailing address

2197 MADISON ST SUITE 109
CLARKSVILLE TN
37043-5284
US

V. Phone/Fax

Practice location:
  • Phone: 931-919-2491
  • Fax: 931-919-2488
Mailing address:
  • Phone: 931-919-2491
  • Fax: 931-919-2488

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License Number29775
License Number StateTN
# 2
Primary TaxonomyN
Taxonomy Code163WD0400X
TaxonomyDiabetes Educator Registered Nurse
License Number29775
License Number StateTN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: