Provider Demographics
NPI:1760083331
Name:TUTTLE, KRISTY LYNN (PHARMD)
Entity Type:Individual
Prefix:
First Name:KRISTY
Middle Name:LYNN
Last Name:TUTTLE
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 1:16280 DRESDEN AVE STE A
Mailing Address - Street 2:
Mailing Address - City:EAST LIVERPOOL
Mailing Address - State:OH
Mailing Address - Zip Code:43920-9025
Mailing Address - Country:US
Mailing Address - Phone:330-386-9813
Mailing Address - Fax:330-386-9815
Practice Address - Street 1:16280 DRESDEN AVE STE A
Practice Address - Street 2:
Practice Address - City:EAST LIVERPOOL
Practice Address - State:OH
Practice Address - Zip Code:43920-9025
Practice Address - Country:US
Practice Address - Phone:330-386-9813
Practice Address - Fax:330-386-9815
Is Sole Proprietor?:Yes
Enumeration Date:2020-11-02
Last Update Date:2020-11-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH03127444183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist