Healthcare Provider Details

I. General information

NPI: 1124612098
Provider Name (Legal Business Name): HEATHER MARSHALL HOLT PHARMD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/22/2021
Last Update Date: 02/22/2021
Certification Date: 02/04/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9352 PARKWEST BLVD
KNOXVILLE TN
37923
US

IV. Provider business mailing address

9352 PARKWEST BLVD
KNOXVILLE TN
37923
US

V. Phone/Fax

Practice location:
  • Phone: 865-373-1042
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1835C0205X
TaxonomyCritical Care Pharmacist
License Number29356
License Number StateTN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: