Healthcare Provider Details

I. General information

NPI: 1063836518
Provider Name (Legal Business Name): WHITNEY DREES PHARMD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/04/2014
Last Update Date: 01/14/2021
Certification Date: 01/14/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2946 WINFIELD DUNN PKWY
KODAK TN
37764-4306
US

IV. Provider business mailing address

2946 WINFIELD DUNN PKWY
KODAK TN
37764-4306
US

V. Phone/Fax

Practice location:
  • Phone: 865-933-4676
  • Fax: 865-933-4501
Mailing address:
  • Phone: 865-933-4676
  • Fax: 865-933-4501

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code183500000X
TaxonomyPharmacist
License Number015509
License Number StateKY
# 2
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License Number38670
License Number StateTN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: