Provider Demographics
NPI:1144864976
Name:WILSON, CAROL ANN (PHARMD)
Entity type:Individual
Prefix:DR
First Name:CAROL ANN
Middle Name:
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 1:3841 GREEN HILLS VILLAGE DR STE 450
Mailing Address - Street 2:
Mailing Address - City:NASHVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37215-2625
Mailing Address - Country:US
Mailing Address - Phone:615-936-9124
Mailing Address - Fax:
Practice Address - Street 1:3841 GREEN HILLS VILLAGE DR STE 450
Practice Address - Street 2:
Practice Address - City:NASHVILLE
Practice Address - State:TN
Practice Address - Zip Code:37215-2625
Practice Address - Country:US
Practice Address - Phone:615-936-9124
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-11-05
Last Update Date:2023-01-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GARPH032798183500000X
TN43219183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist
Provider Identifiers
StateIdentifier IDID TypeIssuer
TN43219OtherPHARMACIST LICENSE NUMBER