Provider Demographics
NPI:1053537894
Name:FARIS, LEANNE MINOR (PHARMD)
Entity type:Individual
Prefix:MRS
First Name:LEANNE
Middle Name:MINOR
Last Name:FARIS
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 1:2020 HEATHER CV
Mailing Address - Street 2:
Mailing Address - City:MEMPHIS
Mailing Address - State:TN
Mailing Address - Zip Code:38119-6339
Mailing Address - Country:US
Mailing Address - Phone:901-683-6613
Mailing Address - Fax:
Practice Address - Street 1:2525 HORIZON LAKE DR
Practice Address - Street 2:SUITE 101
Practice Address - City:MEMPHIS
Practice Address - State:TN
Practice Address - Zip Code:38133-8119
Practice Address - Country:US
Practice Address - Phone:901-248-3700
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-04-18
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN8812183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist