Provider Demographics
NPI:1629197488
Name:SULCER, DONNA LORENE (DPH)
Entity Type:Individual
Prefix:DR
First Name:DONNA
Middle Name:LORENE
Last Name:SULCER
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 1:2794 MAYS BRIDGE RD
Mailing Address - Street 2:
Mailing Address - City:PARIS
Mailing Address - State:TN
Mailing Address - Zip Code:38242-7416
Mailing Address - Country:US
Mailing Address - Phone:731-336-2842
Mailing Address - Fax:
Practice Address - Street 1:100 N 12TH ST
Practice Address - Street 2:
Practice Address - City:MURRAY
Practice Address - State:KY
Practice Address - Zip Code:42071-1912
Practice Address - Country:US
Practice Address - Phone:270-753-2044
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-29
Last Update Date:2022-07-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN0000009095183500000X
KY022867183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist
Provider Identifiers
StateIdentifier IDID TypeIssuer
KY022867OtherPHARMACIST ID NUMBER
TN0000009095OtherPHARMACIST ID NUMBER