Healthcare Provider Details

I. General information

NPI: 1376562967
Provider Name (Legal Business Name): SHELLEY BETH SEAVER R.PH.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/18/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

430 EMORY RD
POWELL TN
37849
US

IV. Provider business mailing address

5741 ALOHA AVE
KNOXVILLE TN
37821
US

V. Phone/Fax

Practice location:
  • Phone: 865-947-5929
  • Fax: 865-947-4664
Mailing address:
  • Phone: 865-766-0416
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License Number4730
License Number StateTN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: