Provider Demographics
NPI:1518621903
Name:PRUDE, WHITNEY RAE (PHARMD)
Entity Type:Individual
Prefix:DR
First Name:WHITNEY
Middle Name:RAE
Last Name:PRUDE
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 1:2362 21ST AVE SE
Mailing Address - Street 2:
Mailing Address - City:ROCHESTER
Mailing Address - State:MN
Mailing Address - Zip Code:55904-5878
Mailing Address - Country:US
Mailing Address - Phone:801-547-7462
Mailing Address - Fax:
Practice Address - Street 1:2362 21ST AVE SE
Practice Address - Street 2:
Practice Address - City:ROCHESTER
Practice Address - State:MN
Practice Address - Zip Code:55904-5878
Practice Address - Country:US
Practice Address - Phone:801-547-7462
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-10-22
Last Update Date:2021-10-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN1227281835P1200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1835P1200XPharmacy Service ProvidersPharmacistPharmacotherapyGroup - Single Specialty