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General NPI Number Information
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NPI Number | 1487171039
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Entity Type | Individual
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Provider Name | ANNA BLAIR BROWN PHARMD
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Gender | Female
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Dates
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Enumeration Date | 08/24/2017
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Last Update Date | 08/24/2017
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Provider Practice Location Address
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Address Line | 984 MAIN ST
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City | SOUTHAVEN
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State | MS
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Zip | 38671-1509
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Country | US
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Telephone | 662-342-1915
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Fax |
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Provider Business Mailing Address
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Address Line | 1434 RIVER ROCK PL APT 104
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City | MEMPHIS
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State | TN
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Zip | 38103-6993
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Country | US
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Telephone | 601-946-1449
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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 | 41506
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License Number State | TN
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Taxonomy #2
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Taxonomy Code | 183500000X
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Taxonomy Name | Pharmacist
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License Number | E-15002
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License Number State | MS
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