Provider Demographics
NPI:1962713818
Name:WILSON, SHEILA C (PHARMD)
Entity type:Individual
Prefix:
First Name:SHEILA
Middle Name:C
Last Name:WILSON
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 1:2289 GUNBARREL RD
Mailing Address - Street 2:
Mailing Address - City:CHATTANOOGA
Mailing Address - State:TN
Mailing Address - Zip Code:37421-2610
Mailing Address - Country:US
Mailing Address - Phone:423-892-4932
Mailing Address - Fax:423-892-1607
Practice Address - Street 1:2225 E WALNUT AVE
Practice Address - Street 2:
Practice Address - City:DALTON
Practice Address - State:GA
Practice Address - Zip Code:30721-4529
Practice Address - Country:US
Practice Address - Phone:706-260-2628
Practice Address - Fax:706-260-2634
Is Sole Proprietor?:No
Enumeration Date:2010-06-25
Last Update Date:2022-12-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN22885183500000X
GA22154183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist