MEDICARE: SYDNEE LEEANN HUMBARD PHARMD

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	46286	TN

General Provider Information

NPI Number	:	1205560166
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	SYDNEE LEEANN HUMBARD PHARMD

Provider Business Mailing Address
First Line	:	13123 KINGSTON PIKE
Second Line	:
City	:	KNOXVILLE
State	:	TN
Zip	:	37934-1008
Country	:	US
Telephone Number	:	865-672-5009
Fax Number	:

Provider Business Practice Location Address
First Line	:	13123 KINGSTON PIKE
Second Line	:
City	:	KNOXVILLE
State	:	TN
Zip	:	37934-1008
Country	:	US
Telephone Number	:	865-672-5009
Fax Number	:

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

Provider Enumeration Date	:	07/14/2022
Last Update Date	:	05/13/2026

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