=====================================================
General NPI Number Information
=====================================================
NPI Number | 1538677109
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | BRANDI NICOLE SCHAFER PHARMD
-----------------------------------------------------
Gender | Female
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 01/17/2018
-----------------------------------------------------
Last Update Date | 01/17/2018
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 615 S CUMBERLAND ST
-----------------------------------------------------
City | LEBANON
-----------------------------------------------------
State | TN
-----------------------------------------------------
Zip | 37087-5107
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 615-449-0611
-----------------------------------------------------
Fax | 615-449-3860
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 615 S CUMBERLAND ST
-----------------------------------------------------
City | LEBANON
-----------------------------------------------------
State | TN
-----------------------------------------------------
Zip | 37087-5107
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 615-449-0611
-----------------------------------------------------
Fax | 615-449-3860
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 183500000X
-----------------------------------------------------
Taxonomy Name | Pharmacist
-----------------------------------------------------
License Number | 37444
-----------------------------------------------------
License Number State | TN
-----------------------------------------------------