Provider Demographics
NPI:1679961916
Name:RANDOLPH, DONNA (PHARMD)
Entity Type:Individual
Prefix:DR
First Name:DONNA
Middle Name:
Last Name:RANDOLPH
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 1:2200 CHILDRENS WAY RM 2106A
Mailing Address - Street 2:
Mailing Address - City:NASHVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37232-0005
Mailing Address - Country:US
Mailing Address - Phone:615-936-6337
Mailing Address - Fax:615-329-9394
Practice Address - Street 1:2200 CHILDRENS WAY RM 2106A
Practice Address - Street 2:
Practice Address - City:NASHVILLE
Practice Address - State:TN
Practice Address - Zip Code:37232-1522
Practice Address - Country:US
Practice Address - Phone:615-936-6337
Practice Address - Fax:615-329-9394
Is Sole Proprietor?:No
Enumeration Date:2015-01-08
Last Update Date:2024-02-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN0000038343183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist