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NPI Code Detail

MEDICARE: KAYLA DIANE CHARRIEZ

MEDICARE: KAYLA DIANE CHARRIEZ
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
1183500000XPharmacist46241TN

General Provider Information

NPI Number : 1205544962
Entity Type Code : Individual
Provider Name (Legal Business Name) : KAYLA DIANE CHARRIEZ
Provider Business Mailing Address
First Line : 2615 LAKE RD
Second Line :
City : DYERSBURG
State : TN
Zip : 38024-1605
Country : US
Telephone Number : 731-288-5065
Fax Number :
Provider Business Practice Location Address
First Line : 2615 LAKE RD
Second Line :
City : DYERSBURG
State : TN
Zip : 38024-1605
Country : US
Telephone Number : 731-288-5065
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 11/11/2022
Last Update Date : 11/11/2022

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Directions to “ KAYLA DIANE CHARRIEZ ” Practice Location

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