Provider Demographics
NPI:1588261481
Name:CRAWFORD, DONNA SHEREE (PHARMD)
Entity type:Individual
Prefix:DR
First Name:DONNA
Middle Name:SHEREE
Last Name:CRAWFORD
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 1:1497 WHISTLE CV
Mailing Address - Street 2:
Mailing Address - City:HORN LAKE
Mailing Address - State:MS
Mailing Address - Zip Code:38637-8515
Mailing Address - Country:US
Mailing Address - Phone:901-288-4580
Mailing Address - Fax:
Practice Address - Street 1:1065 MAIN ST
Practice Address - Street 2:
Practice Address - City:SOUTHAVEN
Practice Address - State:MS
Practice Address - Zip Code:38671-1425
Practice Address - Country:US
Practice Address - Phone:662-393-8527
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-10-04
Last Update Date:2020-10-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN44440183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist