Provider Demographics
NPI:1952801805
Name:TROTTER, BRAMLET DENISE
Entity Type:Individual
Prefix:
First Name:BRAMLET
Middle Name:DENISE
Last Name:TROTTER
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:176 COUNTY ROAD 51
Mailing Address - Street 2:
Mailing Address - City:RICEVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37370
Mailing Address - Country:US
Mailing Address - Phone:423-506-2190
Mailing Address - Fax:
Practice Address - Street 1:1815 DECATUR PIKE
Practice Address - Street 2:
Practice Address - City:ATHENS
Practice Address - State:TN
Practice Address - Zip Code:37303
Practice Address - Country:US
Practice Address - Phone:423-745-1495
Practice Address - Fax:423-745-1389
Is Sole Proprietor?:Yes
Enumeration Date:2018-02-16
Last Update Date:2018-02-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN5589183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist