Provider Demographics
NPI:1710051339
Name:TRUELOVE, ELIZABETH WILSON (RPH)
Entity Type:Individual
Prefix:MRS
First Name:ELIZABETH
Middle Name:WILSON
Last Name:TRUELOVE
Suffix:
Gender:F
Credentials:RPH
Other - Prefix:MRS
Other - First Name:SERRAH
Other - Middle Name:ELIZABETH
Other - Last Name:TRUELOVE
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:R PH
Mailing Address - Street 1:610 STALANS DR
Mailing Address - Street 2:
Mailing Address - City:ETOWAH
Mailing Address - State:TN
Mailing Address - Zip Code:37331-1067
Mailing Address - Country:US
Mailing Address - Phone:423-887-7293
Mailing Address - Fax:423-887-7022
Practice Address - Street 1:18 CHURCH ST
Practice Address - Street 2:
Practice Address - City:ENGLEWOOD
Practice Address - State:TN
Practice Address - Zip Code:37329-3301
Practice Address - Country:US
Practice Address - Phone:423-887-7293
Practice Address - Fax:423-887-7022
Is Sole Proprietor?:No
Enumeration Date:2006-11-17
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN8816183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist