Provider Demographics
NPI:1033712294
Name:MULLER, KRISTEN BETH
Entity Type:Individual
Prefix:
First Name:KRISTEN
Middle Name:BETH
Last Name:MULLER
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:910 PRINCETON DR
Mailing Address - Street 2:
Mailing Address - City:TERRACE PARK
Mailing Address - State:OH
Mailing Address - Zip Code:45174-1265
Mailing Address - Country:US
Mailing Address - Phone:913-314-3694
Mailing Address - Fax:
Practice Address - Street 1:100 RIVERS EDGE
Practice Address - Street 2:
Practice Address - City:MILFORD
Practice Address - State:OH
Practice Address - Zip Code:45150-2585
Practice Address - Country:US
Practice Address - Phone:513-831-5167
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-11-19
Last Update Date:2020-11-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH03337407183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist