Healthcare Provider Details

I. General information

NPI: 1316571508
Provider Name (Legal Business Name): MICHELLE LIU PHARMD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/26/2020
Last Update Date: 02/26/2020
Certification Date: 02/26/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1211 MEDICAL CENTER DR
NASHVILLE TN
37232-0004
US

IV. Provider business mailing address

1808 EDGEHILL AVE APT 6
NASHVILLE TN
37212-2170
US

V. Phone/Fax

Practice location:
  • Phone: 615-875-4410
  • Fax:
Mailing address:
  • Phone: 615-875-4410
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1835P0018X
TaxonomyPharmacist Clinician (PhC)/ Clinical Pharmacy Specialist
License Number0000043757
License Number StateTN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: