Provider Demographics
NPI:1417594516
Name:KNOOP, KRISTINA (PHARMD)
Entity Type:Individual
Prefix:
First Name:KRISTINA
Middle Name:
Last Name:KNOOP
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 1:1710 CHARLESTOWN NEW ALBANY RD # CONDO93
Mailing Address - Street 2:
Mailing Address - City:JEFFERSONVILLE
Mailing Address - State:IN
Mailing Address - Zip Code:47130-9729
Mailing Address - Country:US
Mailing Address - Phone:502-548-3345
Mailing Address - Fax:
Practice Address - Street 1:305 E LEWIS AND CLARK PKWY
Practice Address - Street 2:
Practice Address - City:CLARKSVILLE
Practice Address - State:IN
Practice Address - Zip Code:47129-1758
Practice Address - Country:US
Practice Address - Phone:812-948-8065
Practice Address - Fax:812-948-8090
Is Sole Proprietor?:No
Enumeration Date:2019-12-08
Last Update Date:2019-12-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN26020334A1835P0018X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1835P0018XPharmacy Service ProvidersPharmacistPharmacist Clinician (PhC)/ Clinical Pharmacy Specialist