Healthcare Provider Details

I. General information

NPI: 1255828273
Provider Name (Legal Business Name): KIMBERLY GRACE STONE PHARMD
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: KIMBERLY GRACE HERRINGTON PHARMD

II. Dates (important events)

Enumeration Date: 04/16/2018
Last Update Date: 08/24/2021
Certification Date: 08/24/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

128 COGDILL RD
KNOXVILLE TN
37922-2087
US

IV. Provider business mailing address

128 COGDILL RD
KNOXVILLE TN
37922-2087
US

V. Phone/Fax

Practice location:
  • Phone: 850-532-7020
  • Fax:
Mailing address:
  • Phone: 850-532-7020
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code1835P0018X
TaxonomyPharmacist Clinician (PhC)/ Clinical Pharmacy Specialist
License NumberPS39589
License Number StateFL
# 2
Primary TaxonomyN
Taxonomy Code1835P1200X
TaxonomyPharmacotherapy Pharmacist
License NumberPS39589
License Number StateFL
# 3
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License NumberPS39589
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: