Provider Demographics
NPI:1740515170
Name:TRITTIN, DENISE M (RPH)
Entity type:Individual
Prefix:
First Name:DENISE
Middle Name:M
Last Name:TRITTIN
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 1:108 4TH ST N
Mailing Address - Street 2:
Mailing Address - City:CANNON FALLS
Mailing Address - State:MN
Mailing Address - Zip Code:55009-2036
Mailing Address - Country:US
Mailing Address - Phone:507-263-2881
Mailing Address - Fax:507-263-8702
Practice Address - Street 1:108 4TH ST N
Practice Address - Street 2:
Practice Address - City:CANNON FALLS
Practice Address - State:MN
Practice Address - Zip Code:55009-2036
Practice Address - Country:US
Practice Address - Phone:507-263-2881
Practice Address - Fax:507-263-8702
Is Sole Proprietor?:No
Enumeration Date:2009-10-02
Last Update Date:2009-10-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN115073183500000X
WI12483-040183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist