Provider Demographics
NPI:1588168710
Name:MITCHELL, JULIE ANN (PHARMD)
Entity type:Individual
Prefix:MRS
First Name:JULIE
Middle Name:ANN
Last Name:MITCHELL
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 1:65 MARY JENE CV
Mailing Address - Street 2:
Mailing Address - City:SELMER
Mailing Address - State:TN
Mailing Address - Zip Code:38375-3000
Mailing Address - Country:US
Mailing Address - Phone:731-234-5015
Mailing Address - Fax:731-645-8943
Practice Address - Street 1:1017 MULBERRY AVE
Practice Address - Street 2:
Practice Address - City:SELMER
Practice Address - State:TN
Practice Address - Zip Code:38375-3274
Practice Address - Country:US
Practice Address - Phone:731-645-3207
Practice Address - Fax:731-645-8943
Is Sole Proprietor?:Yes
Enumeration Date:2018-03-21
Last Update Date:2018-03-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN8531183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist