Provider Demographics
NPI:1477837672
Name:ELLIOTT, KRISTIN (PHARMD)
Entity Type:Individual
Prefix:DR
First Name:KRISTIN
Middle Name:
Last Name:ELLIOTT
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 1:260 NEW CIRCLE ROAD NE
Mailing Address - Street 2:
Mailing Address - City:LEXINGTON
Mailing Address - State:KY
Mailing Address - Zip Code:40505
Mailing Address - Country:US
Mailing Address - Phone:859-225-8903
Mailing Address - Fax:859-225-8934
Practice Address - Street 1:260 NEW CIRCLE ROAD NE
Practice Address - Street 2:
Practice Address - City:LEXINGTON
Practice Address - State:KY
Practice Address - Zip Code:40505
Practice Address - Country:US
Practice Address - Phone:859-225-8903
Practice Address - Fax:859-225-8934
Is Sole Proprietor?:No
Enumeration Date:2011-10-06
Last Update Date:2011-10-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY014153183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist