Provider Demographics
NPI:1790258291
Name:MARTIN, KARISTEN (PHARMD)
Entity type:Individual
Prefix:DR
First Name:KARISTEN
Middle Name:
Last Name:MARTIN
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 1:104 MAIN ST
Mailing Address - Street 2:
Mailing Address - City:SAVANNAH
Mailing Address - State:TN
Mailing Address - Zip Code:38372-4999
Mailing Address - Country:US
Mailing Address - Phone:931-676-3318
Mailing Address - Fax:
Practice Address - Street 1:104 MAIN ST
Practice Address - Street 2:
Practice Address - City:CLIFTON
Practice Address - State:TN
Practice Address - Zip Code:38425-5544
Practice Address - Country:US
Practice Address - Phone:931-676-3318
Practice Address - Fax:931-676-3450
Is Sole Proprietor?:No
Enumeration Date:2019-01-07
Last Update Date:2025-01-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN42515183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist