Provider Demographics
NPI:1437812070
Name:RACKLEY, CAYLA NICOLE (PHARMD)
Entity type:Individual
Prefix:
First Name:CAYLA
Middle Name:NICOLE
Last Name:RACKLEY
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 1:1021 COURTFIELD CV
Mailing Address - Street 2:
Mailing Address - City:COLLIERVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:38017-3280
Mailing Address - Country:US
Mailing Address - Phone:901-692-0633
Mailing Address - Fax:
Practice Address - Street 1:824 W POPLAR AVE
Practice Address - Street 2:
Practice Address - City:COLLIERVILLE
Practice Address - State:TN
Practice Address - Zip Code:38017-2579
Practice Address - Country:US
Practice Address - Phone:901-854-3766
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-10-20
Last Update Date:2021-10-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN45484183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist