Provider Demographics
NPI:1710075015
Name:TRAPUZZANO, KATHLEEN ELAINE (RPH)
Entity Type:Individual
Prefix:
First Name:KATHLEEN
Middle Name:ELAINE
Last Name:TRAPUZZANO
Suffix:
Gender:F
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:30 PIPER GLENN
Mailing Address - Street 2:
Mailing Address - City:BLUE RIDGE
Mailing Address - State:VA
Mailing Address - Zip Code:24064-1691
Mailing Address - Country:US
Mailing Address - Phone:540-977-6272
Mailing Address - Fax:
Practice Address - Street 1:2001 CRYSTAL SPRING AVE SW
Practice Address - Street 2:
Practice Address - City:ROANOKE
Practice Address - State:VA
Practice Address - Zip Code:24014-2462
Practice Address - Country:US
Practice Address - Phone:540-853-0905
Practice Address - Fax:540-853-0910
Is Sole Proprietor?:No
Enumeration Date:2006-10-11
Last Update Date:2024-01-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0202206185183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist