Provider Demographics
NPI:1508896234
Name:SUTHERLAND, SUSANNE LYNN (PHARMD)
Entity Type:Individual
Prefix:DR
First Name:SUSANNE
Middle Name:LYNN
Last Name:SUTHERLAND
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:MISS
Other - First Name:SUSANNE
Other - Middle Name:LYNN
Other - Last Name:NOWAK
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:8390 E CRESTHILL DR
Mailing Address - Street 2:
Mailing Address - City:TUCSON
Mailing Address - State:AZ
Mailing Address - Zip Code:85750-2409
Mailing Address - Country:US
Mailing Address - Phone:520-733-6155
Mailing Address - Fax:
Practice Address - Street 1:8390 E CRESTHILL DR
Practice Address - Street 2:
Practice Address - City:TUCSON
Practice Address - State:AZ
Practice Address - Zip Code:85750-2409
Practice Address - Country:US
Practice Address - Phone:520-733-6155
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-05
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ11464183500000X
IL183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist