Healthcare Provider Details

I. General information

NPI: 1700551603
Provider Name (Legal Business Name): JENCI ANZALONE PHARMD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/12/2021
Last Update Date: 02/16/2023
Certification Date: 02/16/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2419 WASHINGTON PIKE
KNOXVILLE TN
37917-3321
US

IV. Provider business mailing address

5708 WASSMAN RD
KNOXVILLE TN
37912-3052
US

V. Phone/Fax

Practice location:
  • Phone: 865-524-3453
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License Number42596
License Number StateTN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: