Provider Demographics
NPI:1861701823
Name:SHAMLIN, KRISTEN LEA MAZANEC (PHARMD)
Entity type:Individual
Prefix:MS
First Name:KRISTEN
Middle Name:LEA MAZANEC
Last Name:SHAMLIN
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 1:5500 CENTRAL AVE STE A
Mailing Address - Street 2:
Mailing Address - City:HOT SPRINGS
Mailing Address - State:AR
Mailing Address - Zip Code:71913-9712
Mailing Address - Country:US
Mailing Address - Phone:501-463-9922
Mailing Address - Fax:501-463-9925
Practice Address - Street 1:5500 CENTRAL AVE STE A
Practice Address - Street 2:
Practice Address - City:HOT SPRINGS
Practice Address - State:AR
Practice Address - Zip Code:71913-9712
Practice Address - Country:US
Practice Address - Phone:501-463-9922
Practice Address - Fax:501-463-9925
Is Sole Proprietor?:No
Enumeration Date:2010-09-24
Last Update Date:2016-09-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ARPD11419183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist