Provider Demographics
NPI:1457954950
Name:WILTSHIRE, TRICIA ALEXANDER (PHARMD)
Entity Type:Individual
Prefix:
First Name:TRICIA
Middle Name:ALEXANDER
Last Name:WILTSHIRE
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 1:15341 MONTANUS DR
Mailing Address - Street 2:
Mailing Address - City:CULPEPER
Mailing Address - State:VA
Mailing Address - Zip Code:22701-2523
Mailing Address - Country:US
Mailing Address - Phone:540-829-6634
Mailing Address - Fax:
Practice Address - Street 1:15341 MONTANUS DR
Practice Address - Street 2:
Practice Address - City:CULPEPER
Practice Address - State:VA
Practice Address - Zip Code:22701-2523
Practice Address - Country:US
Practice Address - Phone:540-829-6634
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-11-17
Last Update Date:2020-11-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0202216157183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist