Provider Demographics
NPI:1306819818
Name:ISAACSON, KRISTINE MILLER (PHARMD, CGP)
Entity Type:Individual
Prefix:DR
First Name:KRISTINE
Middle Name:MILLER
Last Name:ISAACSON
Suffix:
Gender:F
Credentials:PHARMD, CGP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2500 COUNTY ROAD EE
Mailing Address - Street 2:
Mailing Address - City:MULESHOE
Mailing Address - State:TX
Mailing Address - Zip Code:79347-3880
Mailing Address - Country:US
Mailing Address - Phone:806-965-2674
Mailing Address - Fax:
Practice Address - Street 1:2500 COUNTY ROAD EE
Practice Address - Street 2:
Practice Address - City:MULESHOE
Practice Address - State:TX
Practice Address - Zip Code:79347-3880
Practice Address - Country:US
Practice Address - Phone:806-965-2674
Practice Address - Fax:
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-02-08
Last Update Date:2020-12-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX35044183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist