Provider Demographics
NPI:1336703347
Name:WARDEN, CHRISTINA (PHARM D)
Entity Type:Individual
Prefix:DR
First Name:CHRISTINA
Middle Name:
Last Name:WARDEN
Suffix:
Gender:F
Credentials:PHARM D
Other - Prefix:MS
Other - First Name:CHRISTINA
Other - Middle Name:
Other - Last Name:SUDEEN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:1017 NEW HAVEN DR
Mailing Address - Street 2:
Mailing Address - City:CANTONMENT
Mailing Address - State:FL
Mailing Address - Zip Code:32533-6887
Mailing Address - Country:US
Mailing Address - Phone:850-368-4353
Mailing Address - Fax:
Practice Address - Street 1:3880 N 9TH AVE
Practice Address - Street 2:
Practice Address - City:PENSACOLA
Practice Address - State:FL
Practice Address - Zip Code:32503-2802
Practice Address - Country:US
Practice Address - Phone:850-368-4353
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-04-24
Last Update Date:2019-04-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPS49162183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes183500000XPharmacy Service ProvidersPharmacistGroup - Single Specialty