Provider Demographics
NPI:1376857318
Name:KRASNAVAGE, KRISTY (PHARMD)
Entity Type:Individual
Prefix:DR
First Name:KRISTY
Middle Name:
Last Name:KRASNAVAGE
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 1:8 INDEPENDENCE DR
Mailing Address - Street 2:
Mailing Address - City:NORRIDGEWOCK
Mailing Address - State:ME
Mailing Address - Zip Code:04957-3600
Mailing Address - Country:US
Mailing Address - Phone:207-399-9448
Mailing Address - Fax:
Practice Address - Street 1:12 HIGH ST
Practice Address - Street 2:
Practice Address - City:SKOWHEGAN
Practice Address - State:ME
Practice Address - Zip Code:04976-1815
Practice Address - Country:US
Practice Address - Phone:207-474-3393
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-08-02
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MEPR5910183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist