Provider Demographics
NPI:1588295372
Name:TYREE, CHRISTINA (RPH)
Entity type:Individual
Prefix:
First Name:CHRISTINA
Middle Name:
Last Name:TYREE
Suffix:
Gender:F
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1751 NEWNAN CROSSING BLVD E
Mailing Address - Street 2:
Mailing Address - City:NEWNAN
Mailing Address - State:GA
Mailing Address - Zip Code:30265-1517
Mailing Address - Country:US
Mailing Address - Phone:678-423-5845
Mailing Address - Fax:678-423-5846
Practice Address - Street 1:1751 NEWNAN CROSSING BLVD E
Practice Address - Street 2:
Practice Address - City:NEWNAN
Practice Address - State:GA
Practice Address - Zip Code:30265-1517
Practice Address - Country:US
Practice Address - Phone:678-423-5845
Practice Address - Fax:678-423-5846
Is Sole Proprietor?:No
Enumeration Date:2020-01-30
Last Update Date:2020-01-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO136301835P0018X
AZ98001835P0018X
GA261111835P0018X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1835P0018XPharmacy Service ProvidersPharmacistPharmacist Clinician (PhC)/ Clinical Pharmacy Specialist