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General NPI Number Information
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NPI Number | 1831692938
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Entity Type | Individual
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Provider Name | JACKLYN D REDMON PHARMD
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Gender | Female
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Dates
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Enumeration Date | 03/14/2018
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Last Update Date | 03/14/2018
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Provider Practice Location Address
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Address Line | 167 W MAIN ST
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City | MORRISTOWN
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State | TN
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Zip | 37814-4628
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Country | US
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Telephone | 423-581-1118
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Fax |
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Provider Business Mailing Address
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Address Line | 329 HIDDEN VALLEY RD
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City | CLINTON
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State | TN
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Zip | 37716-5834
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Country | US
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Telephone | 423-413-8494
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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 | 41635
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License Number State | TN
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