Healthcare Provider Details

I. General information

NPI: 1396225561
Provider Name (Legal Business Name): ELIZABETH YETT PHARMD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/17/2018
Last Update Date: 03/19/2026
Certification Date: 03/19/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

881 MADISON AVE
MEMPHIS TN
38103-3408
US

IV. Provider business mailing address

881 MADISON AVE
MEMPHIS TN
38103-3408
US

V. Phone/Fax

Practice location:
  • Phone: 901-448-9811
  • Fax:
Mailing address:
  • Phone: 409-659-8292
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License Number42408
License Number StateTN
# 2
Primary TaxonomyN
Taxonomy Code1835P2201X
TaxonomyAmbulatory Care Pharmacist
License Number950666
License Number StateTN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: