Provider Demographics
NPI:1861718082
Name:CUDD, RITA LYNN (RPH)
Entity type:Individual
Prefix:MRS
First Name:RITA
Middle Name:LYNN
Last Name:CUDD
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 1:1621 RIVER RIDGE RD
Mailing Address - Street 2:
Mailing Address - City:RIVER FALLS
Mailing Address - State:WI
Mailing Address - Zip Code:54022-3464
Mailing Address - Country:US
Mailing Address - Phone:715-425-7614
Mailing Address - Fax:
Practice Address - Street 1:1621 RIVER RIDGE RD
Practice Address - Street 2:
Practice Address - City:RIVER FALLS
Practice Address - State:WI
Practice Address - Zip Code:54022-3464
Practice Address - Country:US
Practice Address - Phone:715-425-7614
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-04-13
Last Update Date:2010-04-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI9132040183500000X
MN112297183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist