Provider Demographics
NPI:1083923569
Name:NAQUIN, KRISTAL G
Entity Type:Individual
Prefix:
First Name:KRISTAL
Middle Name:G
Last Name:NAQUIN
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 1:13107 SPLIT CREEK LN
Mailing Address - Street 2:
Mailing Address - City:PEARLAND
Mailing Address - State:TX
Mailing Address - Zip Code:77584-6783
Mailing Address - Country:US
Mailing Address - Phone:985-217-3858
Mailing Address - Fax:
Practice Address - Street 1:13107 SPLIT CREEK LN
Practice Address - Street 2:
Practice Address - City:PEARLAND
Practice Address - State:TX
Practice Address - Zip Code:77584-6783
Practice Address - Country:US
Practice Address - Phone:985-217-3858
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-09-30
Last Update Date:2010-09-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183700000XPharmacy Service ProvidersPharmacy Technician