Provider Demographics
NPI:1033489745
Name:TRUNNELL, NATHAN H (PHARM D)
Entity Type:Individual
Prefix:DR
First Name:NATHAN
Middle Name:H
Last Name:TRUNNELL
Suffix:
Gender:M
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 1:1112 CIVIC CENTER DR NW
Mailing Address - Street 2:
Mailing Address - City:ROCHESTER
Mailing Address - State:MN
Mailing Address - Zip Code:55901-1843
Mailing Address - Country:US
Mailing Address - Phone:507-206-5173
Mailing Address - Fax:507-206-5179
Practice Address - Street 1:1112 CIVIC CENTER DR NW
Practice Address - Street 2:
Practice Address - City:ROCHESTER
Practice Address - State:MN
Practice Address - Zip Code:55901-1843
Practice Address - Country:US
Practice Address - Phone:507-206-5173
Practice Address - Fax:507-206-5179
Is Sole Proprietor?:No
Enumeration Date:2012-01-11
Last Update Date:2012-01-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN119416183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist