Most Relevant Information
Provider Data
| NPI Number: | 1003584855 |
| Provider Name: | DEANNA PUCKETT |
| Entity Type: | Individual |
| Taxonomy Code: | 183500000X |
| Specialty: | Pharmacist |
| License Number: | T17055 |
Most Important Dates
| Enumeration Date: | 09/04/2021 |
| Last Updated: | 09/04/2021 |
Provider Practice Location
2 OLD CAMP RD
FREDERICK
MD
217023740
Practice Location Phone/Fax
| Phone: | 3014734201 |
| Fax: | 3014738995 |
Provider Mailing Location
2 OLD CAMP RD
FREDERICK
MD
217023740
Provider Mailing Phone/Fax
| Phone: | 3014734201 |
| Fax: | 3014738995 |