Provider Demographics
NPI:1326059114
Name:EPPES, KRISTINA R (RPH)
Entity Type:Individual
Prefix:
First Name:KRISTINA
Middle Name:R
Last Name:EPPES
Suffix:
Gender:F
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:718 FALLS BLVD S
Mailing Address - Street 2:
Mailing Address - City:WYNNE
Mailing Address - State:AR
Mailing Address - Zip Code:72396-3514
Mailing Address - Country:US
Mailing Address - Phone:870-238-8531
Mailing Address - Fax:870-238-5982
Practice Address - Street 1:718 FALLS BLVD S
Practice Address - Street 2:
Practice Address - City:WYNNE
Practice Address - State:AR
Practice Address - Zip Code:72396-3514
Practice Address - Country:US
Practice Address - Phone:870-238-8531
Practice Address - Fax:870-238-5982
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-10
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AR7429183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist