Provider Demographics
NPI:1942565940
Name:HULL, JUDY LINN (RPH)
Entity Type:Individual
Prefix:
First Name:JUDY
Middle Name:LINN
Last Name:HULL
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 1:1744 SUBURBAN AVE
Mailing Address - Street 2:#68
Mailing Address - City:SAINT PAUL
Mailing Address - State:MN
Mailing Address - Zip Code:55106-6619
Mailing Address - Country:US
Mailing Address - Phone:651-778-0105
Mailing Address - Fax:
Practice Address - Street 1:1744 SUBURBAN AVE
Practice Address - Street 2:#68
Practice Address - City:SAINT PAUL
Practice Address - State:MN
Practice Address - Zip Code:55106-6619
Practice Address - Country:US
Practice Address - Phone:651-778-0105
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-07-06
Last Update Date:2012-07-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN113720183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist