Healthcare Provider Details

I. General information

NPI: 1649899014
Provider Name (Legal Business Name): HILLARIE MORGAN CLEVLEN PHARMD
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: HILLARIE MORGAN SHIELDS PHARMD

II. Dates (important events)

Enumeration Date: 04/15/2020
Last Update Date: 04/15/2020
Certification Date: 04/15/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2014 QUAIL HOLLOW CIR
FRANKLIN TN
37067-5967
US

IV. Provider business mailing address

3080 OLD MURFREESBORO RD
COLLEGE GROVE TN
37046-8905
US

V. Phone/Fax

Practice location:
  • Phone: 615-663-4691
  • Fax:
Mailing address:
  • Phone: 615-663-4691
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1835P1300X
TaxonomyPsychiatric Pharmacist
License Number38272
License Number StateTN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: