Provider Demographics
NPI:1447300603
Name:SCHLESINGER, DONNA BOALS (DPH)
Entity type:Individual
Prefix:
First Name:DONNA
Middle Name:BOALS
Last Name:SCHLESINGER
Suffix:
Gender:F
Credentials:DPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:55 TURKEY CREEK RD
Mailing Address - Street 2:
Mailing Address - City:HUMBOLDT
Mailing Address - State:TN
Mailing Address - Zip Code:38343-6804
Mailing Address - Country:US
Mailing Address - Phone:731-783-3618
Mailing Address - Fax:
Practice Address - Street 1:609 HWY 45 BYPASS
Practice Address - Street 2:
Practice Address - City:MEDINA
Practice Address - State:TN
Practice Address - Zip Code:38355
Practice Address - Country:US
Practice Address - Phone:783-783-0777
Practice Address - Fax:731-783-3005
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-11
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN6777183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist