Provider Demographics
NPI:1225296866
Name:MONTARELLA, KRISTIN E (PHARMD)
Entity Type:Individual
Prefix:DR
First Name:KRISTIN
Middle Name:E
Last Name:MONTARELLA
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:4401 S WESTERN AVE
Mailing Address - Street 2:ATTN: 200.4180
Mailing Address - City:OKLAHOMA CITY
Mailing Address - State:OK
Mailing Address - Zip Code:73109-3413
Mailing Address - Country:US
Mailing Address - Phone:405-644-6353
Mailing Address - Fax:405-552-5194
Practice Address - Street 1:4401 S WESTERN AVE
Practice Address - Street 2:ATTN: 200.4180
Practice Address - City:OKLAHOMA CITY
Practice Address - State:OK
Practice Address - Zip Code:73109-3413
Practice Address - Country:US
Practice Address - Phone:405-644-6353
Practice Address - Fax:405-552-5194
Is Sole Proprietor?:No
Enumeration Date:2008-05-30
Last Update Date:2008-05-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK130721835P0018X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1835P0018XPharmacy Service ProvidersPharmacistPharmacist Clinician (PhC)/ Clinical Pharmacy Specialist