Provider Demographics
NPI:1669709721
Name:HARKNESS, DEANA LYN (RPH)
Entity type:Individual
Prefix:MRS
First Name:DEANA
Middle Name:LYN
Last Name:HARKNESS
Suffix:
Gender:F
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:615 GEORGE RICHEY RD
Mailing Address - Street 2:
Mailing Address - City:LONGVIEW
Mailing Address - State:TX
Mailing Address - Zip Code:75604-9649
Mailing Address - Country:US
Mailing Address - Phone:903-295-2315
Mailing Address - Fax:
Practice Address - Street 1:615 GEORGE RICHEY RD
Practice Address - Street 2:
Practice Address - City:LONGVIEW
Practice Address - State:TX
Practice Address - Zip Code:75604-9649
Practice Address - Country:US
Practice Address - Phone:903-295-2315
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-11-11
Last Update Date:2009-11-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX42562183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist