Provider Demographics
NPI:1326070301
Name:REIFEL, KRIS WINKLER (RPH,CDM)
Entity Type:Individual
Prefix:MRS
First Name:KRIS
Middle Name:WINKLER
Last Name:REIFEL
Suffix:
Gender:F
Credentials:RPH,CDM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7999 HIGHWAY D
Mailing Address - Street 2:
Mailing Address - City:BATES CITY
Mailing Address - State:MO
Mailing Address - Zip Code:64011-8489
Mailing Address - Country:US
Mailing Address - Phone:816-517-6552
Mailing Address - Fax:
Practice Address - Street 1:601 WEST 40 HIGHWAY
Practice Address - Street 2:
Practice Address - City:BLUE SPRINGS
Practice Address - State:MO
Practice Address - Zip Code:64014
Practice Address - Country:US
Practice Address - Phone:816-224-4277
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-07
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NEPH043643183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist
Provider Identifiers
StateIdentifier IDID TypeIssuer
MO355437310Medicaid
MO355437328Medicaid