Provider Demographics
NPI:1023535812
Name:O'BRIAN, KRISTEN SHAY (PHARM D)
Entity Type:Individual
Prefix:DR
First Name:KRISTEN
Middle Name:SHAY
Last Name:O'BRIAN
Suffix:
Gender:F
Credentials:PHARM D
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:802 EARL FRYE BLVD
Mailing Address - Street 2:
Mailing Address - City:AMORY
Mailing Address - State:MS
Mailing Address - Zip Code:38821-5505
Mailing Address - Country:US
Mailing Address - Phone:662-256-5920
Mailing Address - Fax:
Practice Address - Street 1:107 N MERIDIAN ST
Practice Address - Street 2:
Practice Address - City:ABERDEEN
Practice Address - State:MS
Practice Address - Zip Code:39730-2635
Practice Address - Country:US
Practice Address - Phone:662-369-0060
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-08-23
Last Update Date:2023-05-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MSE-09325183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist