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General NPI Number Information
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NPI Number | 1346368875
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Entity Type | Individual
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Provider Name | SHARON LEE WINGO DPH
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Gender | Female
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Dates
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Enumeration Date | 03/26/2007
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 2232 GALLATIN PIKE N
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City | MADISON
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State | TN
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Zip | 37115-2006
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Country | US
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Telephone | 615-859-6216
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Fax |
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Provider Business Mailing Address
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Address Line | 103 WATTS RD
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City | GOODLETTSVILLE
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State | TN
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Zip | 37072-3800
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Country | US
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Telephone | 615-851-4344
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 183500000X
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Taxonomy Name | Pharmacist
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License Number | C4219
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License Number State | TN
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