Provider Demographics
NPI:1902112972
Name:CUCCIA, ELIZABETH ARLYN (PHARMD)
Entity Type:Individual
Prefix:
First Name:ELIZABETH
Middle Name:ARLYN
Last Name:CUCCIA
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 1:9627 COUNTRYSIDE CENTER LN
Mailing Address - Street 2:
Mailing Address - City:KNOXVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37931-4765
Mailing Address - Country:US
Mailing Address - Phone:865-214-6672
Mailing Address - Fax:865-281-3392
Practice Address - Street 1:9627 COUNTRYSIDE CENTER LN
Practice Address - Street 2:
Practice Address - City:KNOXVILLE
Practice Address - State:TN
Practice Address - Zip Code:37931-4765
Practice Address - Country:US
Practice Address - Phone:865-214-6672
Practice Address - Fax:865-281-3392
Is Sole Proprietor?:No
Enumeration Date:2010-08-27
Last Update Date:2022-12-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN10800183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist