Provider Demographics
NPI:1689412207
Name:BURKHARDT, CHELSEA KATHLEEN (PHARMD)
Entity type:Individual
Prefix:DR
First Name:CHELSEA
Middle Name:KATHLEEN
Last Name:BURKHARDT
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 1:1602 E LAMAR ALEXANDER PKWY
Mailing Address - Street 2:
Mailing Address - City:MARYVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37804-6206
Mailing Address - Country:US
Mailing Address - Phone:865-977-6854
Mailing Address - Fax:
Practice Address - Street 1:1602 E LAMAR ALEXANDER PKWY
Practice Address - Street 2:
Practice Address - City:MARYVILLE
Practice Address - State:TN
Practice Address - Zip Code:37804-6206
Practice Address - Country:US
Practice Address - Phone:865-977-6854
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-07-17
Last Update Date:2024-07-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN48176183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist