Provider Demographics
NPI:1649459629
Name:HENRICH, CHRISTIN (PHARMD, CDE)
Entity type:Individual
Prefix:DR
First Name:CHRISTIN
Middle Name:
Last Name:HENRICH
Suffix:
Gender:F
Credentials:PHARMD, CDE
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4502 W 78TH TER
Mailing Address - Street 2:
Mailing Address - City:PRAIRIE VILLAGE
Mailing Address - State:KS
Mailing Address - Zip Code:66208-4362
Mailing Address - Country:US
Mailing Address - Phone:913-940-1449
Mailing Address - Fax:636-552-0021
Practice Address - Street 1:4502 W 78TH TER
Practice Address - Street 2:
Practice Address - City:PRAIRIE VILLAGE
Practice Address - State:KS
Practice Address - Zip Code:66208-4362
Practice Address - Country:US
Practice Address - Phone:913-940-1449
Practice Address - Fax:636-552-0021
Is Sole Proprietor?:Yes
Enumeration Date:2007-10-26
Last Update Date:2007-10-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS110831835P1200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1835P1200XPharmacy Service ProvidersPharmacistPharmacotherapy