Provider Demographics
NPI:1831692938
Name:REDMON, JACKLYN D (PHARMD)
Entity type:Individual
Prefix:DR
First Name:JACKLYN
Middle Name:D
Last Name:REDMON
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 1:329 HIDDEN VALLEY RD
Mailing Address - Street 2:
Mailing Address - City:CLINTON
Mailing Address - State:TN
Mailing Address - Zip Code:37716-5834
Mailing Address - Country:US
Mailing Address - Phone:423-413-8494
Mailing Address - Fax:
Practice Address - Street 1:167 W MAIN ST
Practice Address - Street 2:
Practice Address - City:MORRISTOWN
Practice Address - State:TN
Practice Address - Zip Code:37814-4628
Practice Address - Country:US
Practice Address - Phone:423-581-1118
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-03-14
Last Update Date:2018-03-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN41635183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist