Provider Demographics
NPI:1467814053
Name:KIRCHNER, KRIS (PHARMD)
Entity Type:Individual
Prefix:DR
First Name:KRIS
Middle Name:
Last Name:KIRCHNER
Suffix:
Gender:M
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2200 17TH ST
Mailing Address - Street 2:
Mailing Address - City:SPIRIT LAKE
Mailing Address - State:IA
Mailing Address - Zip Code:51360-1007
Mailing Address - Country:US
Mailing Address - Phone:712-336-1756
Mailing Address - Fax:712-336-8460
Practice Address - Street 1:2200 17TH ST
Practice Address - Street 2:
Practice Address - City:SPIRIT LAKE
Practice Address - State:IA
Practice Address - Zip Code:51360-1007
Practice Address - Country:US
Practice Address - Phone:712-336-1756
Practice Address - Fax:712-336-8460
Is Sole Proprietor?:No
Enumeration Date:2016-03-23
Last Update Date:2016-03-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA21924183500000X
MN121356183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist