Provider Demographics
NPI:1013021609
Name:COHEN, KRISTINA BALLINGER (PHARMD)
Entity Type:Individual
Prefix:
First Name:KRISTINA
Middle Name:BALLINGER
Last Name:COHEN
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:
Other - First Name:KRISTINA
Other - Middle Name:JOY
Other - Last Name:BALLINGER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:3061 BRIDLE LN
Mailing Address - Street 2:
Mailing Address - City:ANCHORAGE
Mailing Address - State:AK
Mailing Address - Zip Code:99517-1413
Mailing Address - Country:US
Mailing Address - Phone:907-677-2958
Mailing Address - Fax:
Practice Address - Street 1:4320 DIPLOMACY DR
Practice Address - Street 2:ANMC PRIMARY CARE CENTER PHARMACY
Practice Address - City:ANCHORAGE
Practice Address - State:AK
Practice Address - Zip Code:99508-5925
Practice Address - Country:US
Practice Address - Phone:907-729-8874
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-08-19
Last Update Date:2010-07-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WY2988183500000X
AK1737183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist