Provider Demographics
NPI:1295081495
Name:NORTHCOTE, DONNA MARIE (PHARM D)
Entity type:Individual
Prefix:MRS
First Name:DONNA
Middle Name:MARIE
Last Name:NORTHCOTE
Suffix:
Gender:F
Credentials:PHARM D
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1944 ALLEN CT
Mailing Address - Street 2:
Mailing Address - City:JUNEAU
Mailing Address - State:AK
Mailing Address - Zip Code:99801-9598
Mailing Address - Country:US
Mailing Address - Phone:877-658-0304
Mailing Address - Fax:
Practice Address - Street 1:1944 ALLEN CT
Practice Address - Street 2:
Practice Address - City:JUNEAU
Practice Address - State:AK
Practice Address - Zip Code:99801-9598
Practice Address - Country:US
Practice Address - Phone:877-658-0304
Practice Address - Fax:907-802-2242
Is Sole Proprietor?:No
Enumeration Date:2012-07-25
Last Update Date:2019-10-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AKPHAP2233183500000X
AK22331835P1300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1835P1300XPharmacy Service ProvidersPharmacistPsychiatric
Yes183500000XPharmacy Service ProvidersPharmacist
Provider Identifiers
StateIdentifier IDID TypeIssuer
AK2233OtherSTATE LICENSE NUMBER FOR ALASKA