Provider Demographics
NPI:1508858960
Name:FIELDS, DENISE C (PHARMD)
Entity Type:Individual
Prefix:DR
First Name:DENISE
Middle Name:C
Last Name:FIELDS
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 1:4299 S OLD MICHIGAN RD
Mailing Address - Street 2:
Mailing Address - City:HOLTON
Mailing Address - State:IN
Mailing Address - Zip Code:47023-9158
Mailing Address - Country:US
Mailing Address - Phone:812-689-6742
Mailing Address - Fax:
Practice Address - Street 1:806 JACKSON ST
Practice Address - Street 2:
Practice Address - City:COLUMBUS
Practice Address - State:IN
Practice Address - Zip Code:47201
Practice Address - Country:US
Practice Address - Phone:812-799-3287
Practice Address - Fax:812-748-3413
Is Sole Proprietor?:No
Enumeration Date:2005-08-22
Last Update Date:2018-06-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN26017652183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist