Healthcare Provider Details

I. General information

NPI: 1205277647
Provider Name (Legal Business Name): MICHELL WENDY ZULU PHARMD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/15/2013
Last Update Date: 02/16/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3860 AUSTIN PEAY HWY
MEMPHIS TN
38128-2501
US

IV. Provider business mailing address

3860 AUSTIN PEAY HWY
MEMPHIS TN
38128-2501
US

V. Phone/Fax

Practice location:
  • Phone: 901-383-4847
  • Fax: 901-383-4848
Mailing address:
  • Phone: 901-383-4847
  • Fax: 901-383-4848

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License Number37561
License Number StateTN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: