Provider Demographics
NPI:1144703711
Name:PFEIFER, KRISTEN M
Entity type:Individual
Prefix:
First Name:KRISTEN
Middle Name:M
Last Name:PFEIFER
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 1:23731 HARVARD ST
Mailing Address - Street 2:
Mailing Address - City:DEARBORN
Mailing Address - State:MI
Mailing Address - Zip Code:48124-2541
Mailing Address - Country:US
Mailing Address - Phone:734-578-2986
Mailing Address - Fax:
Practice Address - Street 1:23731 HARVARD ST
Practice Address - Street 2:
Practice Address - City:DEARBORN
Practice Address - State:MI
Practice Address - Zip Code:48124-2541
Practice Address - Country:US
Practice Address - Phone:734-578-2986
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-09-10
Last Update Date:2018-09-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174H00000XOther Service ProvidersHealth Educator