Provider Demographics
NPI:1902404403
Name:COLLETTE, DEBORAH TRAMEL (RPH)
Entity Type:Individual
Prefix:
First Name:DEBORAH
Middle Name:TRAMEL
Last Name:COLLETTE
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 1:708 CLEERMONT DR SE
Mailing Address - Street 2:
Mailing Address - City:HUNTSVILLE
Mailing Address - State:AL
Mailing Address - Zip Code:35801-1842
Mailing Address - Country:US
Mailing Address - Phone:256-527-5050
Mailing Address - Fax:
Practice Address - Street 1:6070 MOORES MILL RD
Practice Address - Street 2:
Practice Address - City:HUNTSVILLE
Practice Address - State:AL
Practice Address - Zip Code:35811-9260
Practice Address - Country:US
Practice Address - Phone:256-852-4267
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-10-15
Last Update Date:2020-10-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL113441835P0018X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1835P0018XPharmacy Service ProvidersPharmacistPharmacist Clinician (PhC)/ Clinical Pharmacy Specialist