Provider Demographics
NPI:1366573446
Name:DEGAN, SUZANNE BURNS (PHARM D)
Entity type:Individual
Prefix:MRS
First Name:SUZANNE
Middle Name:BURNS
Last Name:DEGAN
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 1:2752 SCARLET RD
Mailing Address - Street 2:
Mailing Address - City:GERMANTOWN
Mailing Address - State:TN
Mailing Address - Zip Code:38139-7902
Mailing Address - Country:US
Mailing Address - Phone:901-754-0270
Mailing Address - Fax:
Practice Address - Street 1:132 BLOCK ST
Practice Address - Street 2:
Practice Address - City:MARION
Practice Address - State:AR
Practice Address - Zip Code:72364-1956
Practice Address - Country:US
Practice Address - Phone:870-739-4400
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-03-08
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AR8373183500000X
TN94631835N0905X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered183500000XPharmacy Service ProvidersPharmacist
Not Answered1835N0905XPharmacy Service ProvidersPharmacistNuclear