Provider Demographics
NPI:1457955049
Name:RUTH, DENISE LYNNE (PHARMD)
Entity Type:Individual
Prefix:MS
First Name:DENISE
Middle Name:LYNNE
Last Name:RUTH
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 1:1196 ABBE CREEK RD
Mailing Address - Street 2:
Mailing Address - City:MOUNT VERNON
Mailing Address - State:IA
Mailing Address - Zip Code:52314-9726
Mailing Address - Country:US
Mailing Address - Phone:319-895-4084
Mailing Address - Fax:
Practice Address - Street 1:1196 ABBE CREEK RD
Practice Address - Street 2:
Practice Address - City:MOUNT VERNON
Practice Address - State:IA
Practice Address - Zip Code:52314-9726
Practice Address - Country:US
Practice Address - Phone:319-895-4084
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-11-24
Last Update Date:2020-11-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA164951835P0018X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1835P0018XPharmacy Service ProvidersPharmacistPharmacist Clinician (PhC)/ Clinical Pharmacy Specialist