Provider Demographics
NPI:1871710590
Name:MASLYN, VICTORIA M (DPH)
Entity type:Individual
Prefix:
First Name:VICTORIA
Middle Name:M
Last Name:MASLYN
Suffix:
Gender:F
Credentials:DPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:823 GEORGEBORO CT
Mailing Address - Street 2:
Mailing Address - City:BRENTWOOD
Mailing Address - State:TN
Mailing Address - Zip Code:37027-6105
Mailing Address - Country:US
Mailing Address - Phone:615-371-8795
Mailing Address - Fax:
Practice Address - Street 1:500 WILSON PIKE CIR
Practice Address - Street 2:SUITE 115
Practice Address - City:BRENTWOOD
Practice Address - State:TN
Practice Address - Zip Code:37027-5252
Practice Address - Country:US
Practice Address - Phone:615-726-0776
Practice Address - Fax:615-726-8887
Is Sole Proprietor?:No
Enumeration Date:2007-04-20
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN9892183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist