Provider Demographics
NPI:1487238267
Name:HARDIN, HOLLI L (PHARM D)
Entity type:Individual
Prefix:
First Name:HOLLI
Middle Name:L
Last Name:HARDIN
Suffix:
Gender:F
Credentials:PHARM D
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:941 ROSEDALE AVE
Mailing Address - Street 2:
Mailing Address - City:KINGSTON
Mailing Address - State:TN
Mailing Address - Zip Code:37763-2618
Mailing Address - Country:US
Mailing Address - Phone:865-621-2074
Mailing Address - Fax:
Practice Address - Street 1:3588 WORKMAN RD STE 101
Practice Address - Street 2:
Practice Address - City:KNOXVILLE
Practice Address - State:TN
Practice Address - Zip Code:37921-5932
Practice Address - Country:US
Practice Address - Phone:865-558-8733
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-05-08
Last Update Date:2021-05-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN41658183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist