Provider Demographics
NPI:1316232440
Name:VENABLE, SUZANNE LYNN (RPH)
Entity type:Individual
Prefix:MRS
First Name:SUZANNE
Middle Name:LYNN
Last Name:VENABLE
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 1:1037 S REED RD
Mailing Address - Street 2:TARGET (T-0111)
Mailing Address - City:KOKOMO
Mailing Address - State:IN
Mailing Address - Zip Code:46902-1929
Mailing Address - Country:US
Mailing Address - Phone:765-868-9158
Mailing Address - Fax:
Practice Address - Street 1:1037 S REED RD
Practice Address - Street 2:TARGET (T-0111)
Practice Address - City:KOKOMO
Practice Address - State:IN
Practice Address - Zip Code:46902-1929
Practice Address - Country:US
Practice Address - Phone:765-868-9158
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-06-16
Last Update Date:2011-06-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN26015615A183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist