Provider Demographics
NPI:1316231434
Name:KNICKLE, CHRISTINA (PHARM D)
Entity Type:Individual
Prefix:DR
First Name:CHRISTINA
Middle Name:
Last Name:KNICKLE
Suffix:
Gender:F
Credentials:PHARM D
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:606 COLISEUM DR
Mailing Address - Street 2:
Mailing Address - City:WINSTON SALEM
Mailing Address - State:NC
Mailing Address - Zip Code:27106-5311
Mailing Address - Country:US
Mailing Address - Phone:336-727-8680
Mailing Address - Fax:336-727-4858
Practice Address - Street 1:606 COLISEUM DR
Practice Address - Street 2:
Practice Address - City:WINSTON SALEM
Practice Address - State:NC
Practice Address - Zip Code:27106-5311
Practice Address - Country:US
Practice Address - Phone:336-727-8680
Practice Address - Fax:336-727-4858
Is Sole Proprietor?:No
Enumeration Date:2011-06-06
Last Update Date:2011-06-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC20655183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist