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NPI Code Detail

MEDICARE: BROOKLYN NELSON PHARMD

MEDICARE:   BROOKLYN  NELSON  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
1183500000XPharmacist23710NC

General Provider Information

NPI Number : 1982036927
Entity Type Code : Individual
Provider Name (Legal Business Name) : BROOKLYN NELSON PHARMD
Provider Business Mailing Address
First Line : 1021 W OAKLAND AVE STE 301
Second Line :
City : JOHNSON CITY
State : TN
Zip : 37604-2192
Country : US
Telephone Number : 812-201-7976
Fax Number :
Provider Business Practice Location Address
First Line : 1021 W OAKLAND AVE STE 301
Second Line :
City : JOHNSON CITY
State : TN
Zip : 37604-2192
Country : US
Telephone Number : 812-201-7976
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/01/2013
Last Update Date : 03/17/2018

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Directions to “ BROOKLYN NELSON PHARMD” Practice Location

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