MEDICARE: KELLEY RENEE LEDET PHARM D

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	183500000X	Pharmacist	0000036775	TN

General Provider Information

NPI Number	:	1083968598
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	KELLEY RENEE LEDET PHARM D

Provider Business Mailing Address
First Line	:	8000 CLOVERLAND DRIVE
Second Line	:
City	:	NASHVILLE
State	:	TN
Zip	:	37211-6702
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	1106 NORTH MAIN STREET
Second Line	:
City	:	CROSSVILLE
State	:	TN
Zip	:	38555-4059
Country	:	US
Telephone Number	:	931-484-4388
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	11/06/2012
Last Update Date	:	11/06/2012

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Directions to “ KELLEY RENEE LEDET PHARM D” Practice Location

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