Provider Demographics
NPI:1003164328
Name:PAPPAS, KATERINA ELAINE (PHARMD)
Entity Type:Individual
Prefix:
First Name:KATERINA
Middle Name:ELAINE
Last Name:PAPPAS
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 1:1900 LAKESHORE DR
Mailing Address - Street 2:
Mailing Address - City:TUPELO
Mailing Address - State:MS
Mailing Address - Zip Code:38804-1112
Mailing Address - Country:US
Mailing Address - Phone:662-372-4902
Mailing Address - Fax:
Practice Address - Street 1:4616 HIGHWAY 280
Practice Address - Street 2:
Practice Address - City:BIRMINGHAM
Practice Address - State:AL
Practice Address - Zip Code:35242-5028
Practice Address - Country:US
Practice Address - Phone:205-991-6248
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-08-16
Last Update Date:2012-08-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL17197183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist