Provider Demographics
NPI:1386373116
Name:HESSER, SHELBY (PHARMD)
Entity type:Individual
Prefix:DR
First Name:SHELBY
Middle Name:
Last Name:HESSER
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 1:4670 LEBANON PIKE
Mailing Address - Street 2:
Mailing Address - City:HERMITAGE
Mailing Address - State:TN
Mailing Address - Zip Code:37076-1314
Mailing Address - Country:US
Mailing Address - Phone:575-430-8489
Mailing Address - Fax:
Practice Address - Street 1:4670 LEBANON PIKE
Practice Address - Street 2:
Practice Address - City:HERMITAGE
Practice Address - State:TN
Practice Address - Zip Code:37076-1314
Practice Address - Country:US
Practice Address - Phone:615-874-2216
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-06-07
Last Update Date:2024-02-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC32823183500000X
COPHA.0024170183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist