POLLY ELIZABETH WILSON (NPI# 1609158393) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1609158393 |
| Entity Type | Individual |
| Full Name | POLLY ELIZABETH WILSON |
| Other Name | POLLY ELIZABETH FUNK |
| Credential | PHARMD |
| Practice Address |
2399 Mcgrady Dr Se Cleveland TN 37323-7147 |
| Mailing Address |
7626 Prince Dr Ooltewah TN 37363-7148 |
| Practice Telephone | 4235599094 |
| Practice Fax Number | 4235599116 |
| Mailing Telephone | 4239100259 |
| Enumeration Date | 2011-09-19 |
| Last Update Date | 2011-09-19 |
| Gender Code | F |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 183500000X | Pharmacist | 27713 | TN | Pharmacy Service Providers |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1437594652 | Polly Ann Wilson | Social Worker | 279 Summit Dr, Waterford, MI 48328-3364 | 2013-05-01 |
| 1508150350 | Polly Wilson | Counselor | 2502 Crossroads Dr, B, Ardmore, OK 73401-2503 | 2011-06-08 |
| Street Address |
2399 MCGRADY DR SE |
| City | CLEVELAND |
| State | TN |
| Zip Code | 37323-7147 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1134134174 | Walgreen Co | Pharmacy | 2399 Mcgrady Dr Se, Cleveland, TN 37323-7147 | 2006-07-29 |
| 1215548177 | Lindsey Diederich | Pharmacist | 2399 Mcgrady Dr Se, Cleveland, TN 37323-7147 | 2020-08-13 |
| 1457663262 | Dennis Neal Foskey | Pharmacist | 2399 Mcgrady Dr Se, Cleveland, TN 37323-7147 | 2010-07-09 |
| 1548572746 | Rose Branstutter | Pharmacist | 2399 Mcgrady Dr Se, Cleveland, TN 37323-7147 | 2010-07-06 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1477066082 | Quadmed Medical Clinics of Wisconsin, S.c. D/b/a Quadmed Medical Group | Registered Nurse | 2525 Benton Pike Ne, Cleveland, TN 37323 | 2017-11-06 |
| 1679877518 | Life Bridges, Inc. | Intermediate Care Facility, Mentally Retarded | 207 Kile Lake Road, Cleveland, TN 37323 | 2011-01-07 |
| 1376847251 | Life Bridges, Inc. | Intermediate Care Facility, Mentally Retarded | 209 Kile Lake Road, Cleveland, TN 37323 | 2011-01-06 |
| 1508084302 | Karen Elizabeth Gannon | Nurse Practitioner | 11111 Doctor's Office Tower, 2200 Children's Way, Nashville, TN 37323 | 2007-04-24 |
| 1235353566 | Melissa D Townsend | Specialist/Technologist, Other | 120 Fern Drive, Cleveland, TN 37323 | 2007-04-11 |
| 1306965686 | David Wayne Miolen | Dentist | 2648 Apd 40, Cleveland, TN 37323 | 2007-03-28 |
| 1780751933 | Linda Fay Wooten | Driver | 2259 Spring Place Rd Se, Cleveland, TN 37323 | 2006-11-30 |
| 1487134482 | Kristy Alese Henegar | Nurse Practitioner | 1420 Fritz St Se, Cleveland, TN 37323 | 2018-08-19 |
| 1417577537 | Eduardo Trevino | Family Medicine | 3009 Midfield Cir Se, Cleveland, TN 37323-0554 | 2020-04-18 |
| 1831339589 | Lyle Foster Johnson | Occupational Therapy Assistant | 2657 Apd 40, Cleveland, TN 37323-0696 | 2009-02-20 |
| Find all providers in zip 37323 | ||||
| Taxonomy Code | 183500000X |
| Grouping | Pharmacy Service Providers |
| Classification | Pharmacist |
| An individual licensed by the appropriate state regulatory agency to engage in the practice of pharmacy. The practice of pharmacy includes, but is not limited to, assessment, interpretation, evaluation, and implementation, initiation, monitoring or modification of medication and or medical orders; the compounding or dispensing of medication and or medical orders; participation in drug and device procurement, storage, and selection; drug administration; drug regimen reviews; drug or drug-related research; provision of patient education and the provision of those acts or services necessary to provide medication therapy management services in all areas of patient care. |
| Notes: Source: Adapted from National Association of Boards of Pharmacy Model State Pharmacy Act, Article 1, Section 104. [1/1/2006: definition modified, source modified] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1659972305 | Rosemary Jean Snow | Pharmacist | 5841 W 130th St, Cleveland, OH 44130-9308 | 2020-11-07 |
| 1811513377 | Anthony Wasielewski | Pharmacist | 1415 W 112th St Apt 23, Cleveland, OH 44102-2371 | 2020-06-21 |
| 1306495320 | Letha Rebecca Gilbert | Pharmacist | 240 Starlet Cir Ne, Cleveland, TN 37323-6416 | 2019-09-11 |
| 1295388205 | Mai Nguyen | Pharmacist | 10701 East Blvd # 119, Cleveland, OH 44106-1702 | 2019-07-18 |
| 1457847485 | Tammy Griffin | Pharmacist | 84 Cleveland Highway, Cleveland, GA 30528-7804 | 2018-07-02 |
| 1699282533 | Jignasa Bhavin Patel | Pharmacist | 5727 Avenwood Cir Nw, Cleveland, TN 37312-8235 | 2018-01-01 |
| 1497270425 | Peter A Wirkowski | Pharmacist | 1730 W 25th St Dept Of, Cleveland, OH 44113-3108 | 2017-08-10 |
| 1376079699 | Anna Vanbenschoten | Pharmacist | 300 25th St Ne, Apt 6034, Cleveland, TN 37311-3991 | 2017-05-05 |
| 1699215772 | Patricia Anne Caffrey | Pharmacist | 9885 Rockside Rd, Suite 157, Cleveland, OH 44125-6273 | 2017-03-08 |
| 1437517737 | Souhail Francis | Pharmacist | 13412 Sprecher Ave, Cleveland, OH 44135-5050 | 2016-02-02 |
| Find all providers in CLEVELAND | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.