Provider Demographics
NPI:1083944060
Name:WEBSTER, KRISTEN (PHARMD)
Entity Type:Individual
Prefix:DR
First Name:KRISTEN
Middle Name:
Last Name:WEBSTER
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:DR
Other - First Name:KRISTEN
Other - Middle Name:
Other - Last Name:LEE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PHARMD
Mailing Address - Street 1:4175 S ALAMO AVENUE
Mailing Address - Street 2:
Mailing Address - City:DAVIS-MONTH AFB
Mailing Address - State:AZ
Mailing Address - Zip Code:85707-3004
Mailing Address - Country:US
Mailing Address - Phone:520-228-1923
Mailing Address - Fax:
Practice Address - Street 1:4175 S ALAMO AVENUE
Practice Address - Street 2:BUILDING 400
Practice Address - City:DAVIS-MONTHAN AFB
Practice Address - State:AZ
Practice Address - Zip Code:85707
Practice Address - Country:US
Practice Address - Phone:520-228-1923
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-01-13
Last Update Date:2023-10-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN26022566A183500000X
AZS016250183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist