Provider Demographics
NPI:1194245696
Name:PRENTICE, JANET WRIGHT (DPH)
Entity type:Individual
Prefix:
First Name:JANET
Middle Name:WRIGHT
Last Name:PRENTICE
Suffix:
Gender:F
Credentials:DPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3343 MEMORIAL BLVD APT B123
Mailing Address - Street 2:
Mailing Address - City:MURFREESBORO
Mailing Address - State:TN
Mailing Address - Zip Code:37129-5420
Mailing Address - Country:US
Mailing Address - Phone:615-579-1091
Mailing Address - Fax:
Practice Address - Street 1:5171 SAM JARED DR
Practice Address - Street 2:
Practice Address - City:MURFREESBORO
Practice Address - State:TN
Practice Address - Zip Code:37130-1382
Practice Address - Country:US
Practice Address - Phone:615-579-1091
Practice Address - Fax:615-579-1091
Is Sole Proprietor?:No
Enumeration Date:2017-06-26
Last Update Date:2017-06-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN6511183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist