Provider Demographics
NPI:1467751842
Name:EDWARDS, CHRISTI (RPH)
Entity Type:Individual
Prefix:
First Name:CHRISTI
Middle Name:
Last Name:EDWARDS
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 1:408 N MORGAN ST
Mailing Address - Street 2:
Mailing Address - City:MORGANFIELD
Mailing Address - State:KY
Mailing Address - Zip Code:42437-1240
Mailing Address - Country:US
Mailing Address - Phone:270-389-4556
Mailing Address - Fax:270-389-9496
Practice Address - Street 1:408 N MORGAN ST
Practice Address - Street 2:
Practice Address - City:MORGANFIELD
Practice Address - State:KY
Practice Address - Zip Code:42437-1240
Practice Address - Country:US
Practice Address - Phone:270-389-4556
Practice Address - Fax:270-389-9496
Is Sole Proprietor?:Yes
Enumeration Date:2011-03-24
Last Update Date:2011-03-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY8896183500000X
IN26092064A183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist