Provider Demographics
NPI:1285942748
Name:WHEELER, CHRISTY (PHARMD)
Entity type:Individual
Prefix:
First Name:CHRISTY
Middle Name:
Last Name:WHEELER
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1409 S ADAMS ST STE A
Mailing Address - Street 2:
Mailing Address - City:FULTON
Mailing Address - State:MS
Mailing Address - Zip Code:38843-7629
Mailing Address - Country:US
Mailing Address - Phone:662-862-3361
Mailing Address - Fax:662-862-4546
Practice Address - Street 1:1409 S ADAMS ST STE A
Practice Address - Street 2:
Practice Address - City:FULTON
Practice Address - State:MS
Practice Address - Zip Code:38843-7629
Practice Address - Country:US
Practice Address - Phone:662-862-3361
Practice Address - Fax:662-862-4546
Is Sole Proprietor?:No
Enumeration Date:2010-09-18
Last Update Date:2010-09-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MSE-08241183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist