Provider Demographics
NPI:1861537706
Name:ALSUP, KATHERINE LUCIUS (PHARM D)
Entity type:Individual
Prefix:MRS
First Name:KATHERINE
Middle Name:LUCIUS
Last Name:ALSUP
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 1:4020 OVERBROOK DR
Mailing Address - Street 2:
Mailing Address - City:NASHVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37204-4311
Mailing Address - Country:US
Mailing Address - Phone:615-385-3735
Mailing Address - Fax:
Practice Address - Street 1:608 ENON SPRINGS RD E
Practice Address - Street 2:
Practice Address - City:SMYRNA
Practice Address - State:TN
Practice Address - Zip Code:37167-4410
Practice Address - Country:US
Practice Address - Phone:615-220-5432
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-02-20
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN11152183500000X
FL35562183500000X
GA19446183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist