Provider Demographics
NPI:1316534647
Name:ZWERNEMANN, KRISTA (PHARMD)
Entity Type:Individual
Prefix:DR
First Name:KRISTA
Middle Name:
Last Name:ZWERNEMANN
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:455 HIGHWAY 36 NORTH
Mailing Address - Street 2:
Mailing Address - City:CALDWELL
Mailing Address - State:TX
Mailing Address - Zip Code:77836
Mailing Address - Country:US
Mailing Address - Phone:979-567-1446
Mailing Address - Fax:979-567-9437
Practice Address - Street 1:455 HIGHWAY 36 NORTH
Practice Address - Street 2:
Practice Address - City:CALDWELL
Practice Address - State:TX
Practice Address - Zip Code:77836
Practice Address - Country:US
Practice Address - Phone:979-567-1446
Practice Address - Fax:979-567-9437
Is Sole Proprietor?:Yes
Enumeration Date:2020-12-21
Last Update Date:2020-12-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX47428183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist