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General NPI Number Information
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NPI Number | 1588291538
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Entity Type | Individual
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Provider Name | AMANDA SMELTZER GIBSON PHARMD
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Gender | Female
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Dates
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Enumeration Date | 03/26/2020
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Last Update Date | 03/26/2020
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Provider Practice Location Address
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Address Line | 10820 PARKSIDE DR
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City | KNOXVILLE
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State | TN
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Zip | 37934-1956
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Country | US
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Telephone | 865-218-7075
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Fax |
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Provider Business Mailing Address
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Address Line | 559 OLD GLORY RD
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City | MARYVILLE
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State | TN
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Zip | 37801-7843
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Country | US
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Telephone | 865-776-1171
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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 | 33079
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License Number State | TN
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