Provider Demographics
NPI:1962059378
Name:DENNER, CATHERINE LYNN (PHARMD)
Entity type:Individual
Prefix:DR
First Name:CATHERINE
Middle Name:LYNN
Last Name:DENNER
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:DR
Other - First Name:CATHERINE
Other - Middle Name:LYNN
Other - Last Name:LEDBETTER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PHARMD
Mailing Address - Street 1:330 OAK HILL LN
Mailing Address - Street 2:
Mailing Address - City:CANTON
Mailing Address - State:GA
Mailing Address - Zip Code:30115-5433
Mailing Address - Country:US
Mailing Address - Phone:678-551-2499
Mailing Address - Fax:
Practice Address - Street 1:330 OAK HILL LN
Practice Address - Street 2:
Practice Address - City:CANTON
Practice Address - State:GA
Practice Address - Zip Code:30115-5433
Practice Address - Country:US
Practice Address - Phone:678-551-2499
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-08-20
Last Update Date:2019-08-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GARPH019936183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA1Medicaid