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General NPI Number Information
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NPI Number | 1689707226
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Entity Type | Individual
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Provider Name | ELLEN ADELE PHILLIPS PHARM D
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Gender | Female
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Dates
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Enumeration Date | 03/13/2007
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 5941 KINGSTON PIKE
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City | KNOXVILLE
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State | TN
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Zip | 37919-6344
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Country | US
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Telephone | 865-588-0972
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Fax | 865-588-6242
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Provider Business Mailing Address
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Address Line | 717 DAWSON CREEK LN
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City | KNOXVILLE
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State | TN
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Zip | 37922-9007
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Country | US
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Telephone | 865-692-1805
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Fax | 865-692-4246
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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 | 10417
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License Number State | TN
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