Provider Demographics
NPI:1144858465
Name:BUCKLAND, KRYSTEL ALENE (PHARMD, RPH)
Entity type:Individual
Prefix:
First Name:KRYSTEL
Middle Name:ALENE
Last Name:BUCKLAND
Suffix:
Gender:F
Credentials:PHARMD, RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1921 14TH ST W
Mailing Address - Street 2:
Mailing Address - City:BILLINGS
Mailing Address - State:MT
Mailing Address - Zip Code:59102-3113
Mailing Address - Country:US
Mailing Address - Phone:406-861-3404
Mailing Address - Fax:
Practice Address - Street 1:1921 14TH ST W
Practice Address - Street 2:
Practice Address - City:BILLINGS
Practice Address - State:MT
Practice Address - Zip Code:59102-3113
Practice Address - Country:US
Practice Address - Phone:406-861-3404
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-03-31
Last Update Date:2020-04-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MT6260183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist