Provider Demographics
NPI:1740965979
Name:SAPP, TERRICA (PHARMD)
Entity type:Individual
Prefix:
First Name:TERRICA
Middle Name:
Last Name:SAPP
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 1:4121 COMMONS DR W APT 2110
Mailing Address - Street 2:
Mailing Address - City:DESTIN
Mailing Address - State:FL
Mailing Address - Zip Code:32541-8495
Mailing Address - Country:US
Mailing Address - Phone:404-860-3668
Mailing Address - Fax:
Practice Address - Street 1:797 HIGHWAY 98 E
Practice Address - Street 2:
Practice Address - City:DESTIN
Practice Address - State:FL
Practice Address - Zip Code:32541-2522
Practice Address - Country:US
Practice Address - Phone:850-837-8111
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-06-15
Last Update Date:2023-06-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPS65326183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist