Provider Demographics
NPI:1679457527
Name:MANIS, GRACIE CHRISTINE (PHARMD)
Entity type:Individual
Prefix:
First Name:GRACIE
Middle Name:CHRISTINE
Last Name:MANIS
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 1:110 MAJESTIC GROVE RD
Mailing Address - Street 2:
Mailing Address - City:KNOXVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37920-6485
Mailing Address - Country:US
Mailing Address - Phone:865-573-7901
Mailing Address - Fax:
Practice Address - Street 1:110 MAJESTIC GROVE RD
Practice Address - Street 2:
Practice Address - City:KNOXVILLE
Practice Address - State:TN
Practice Address - Zip Code:37920-6485
Practice Address - Country:US
Practice Address - Phone:865-573-7901
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-08-04
Last Update Date:2025-08-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN49041183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist