Provider Demographics
NPI:1043532856
Name:GLEATON, KRISALYN K (PHARMD)
Entity Type:Individual
Prefix:DR
First Name:KRISALYN
Middle Name:K
Last Name:GLEATON
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 1:1122 RANDOLPH ST
Mailing Address - Street 2:
Mailing Address - City:THOMASVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:27360-5175
Mailing Address - Country:US
Mailing Address - Phone:336-476-8190
Mailing Address - Fax:336-476-5042
Practice Address - Street 1:1122 RANDOLPH ST
Practice Address - Street 2:
Practice Address - City:THOMASVILLE
Practice Address - State:NC
Practice Address - Zip Code:27360-5175
Practice Address - Country:US
Practice Address - Phone:336-476-8190
Practice Address - Fax:336-476-5042
Is Sole Proprietor?:Yes
Enumeration Date:2010-02-20
Last Update Date:2010-02-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC19144183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist