Provider Demographics
NPI:1518039585
Name:ROBBINS, KRISTEN JOAN (PHARMD)
Entity type:Individual
Prefix:
First Name:KRISTEN
Middle Name:JOAN
Last Name:ROBBINS
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:775 KELLY LN
Mailing Address - Street 2:
Mailing Address - City:MISSOULA
Mailing Address - State:MT
Mailing Address - Zip Code:59804-2947
Mailing Address - Country:US
Mailing Address - Phone:406-251-5905
Mailing Address - Fax:
Practice Address - Street 1:1211 S RESERVE ST # 102
Practice Address - Street 2:
Practice Address - City:MISSOULA
Practice Address - State:MT
Practice Address - Zip Code:59801-3101
Practice Address - Country:US
Practice Address - Phone:406-546-9488
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-15
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MT3902183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist
Provider Identifiers
StateIdentifier IDID TypeIssuer
MT3902OtherSTATE LICENSE NUMBER