Provider Demographics
NPI:1710864467
Name:BARRERA VITE, AILEEN ITHZEL
Entity type:Individual
Prefix:
First Name:AILEEN
Middle Name:ITHZEL
Last Name:BARRERA VITE
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:87 MEADOWVIEW LN
Mailing Address - Street 2:
Mailing Address - City:CROSSVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:38555-5273
Mailing Address - Country:US
Mailing Address - Phone:931-337-4130
Mailing Address - Fax:
Practice Address - Street 1:5021 HUGHES XING
Practice Address - Street 2:
Practice Address - City:FRANKLIN
Practice Address - State:TN
Practice Address - Zip Code:37064-1735
Practice Address - Country:US
Practice Address - Phone:615-595-2025
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-08-16
Last Update Date:2025-08-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN49216183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist