Provider Demographics
NPI:1497037089
Name:WHIDDON, KRISTEN HICKS (PHARM D)
Entity Type:Individual
Prefix:MRS
First Name:KRISTEN
Middle Name:HICKS
Last Name:WHIDDON
Suffix:
Gender:F
Credentials:PHARM D
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:400 OXFORD EXCHANGE BLVD
Mailing Address - Street 2:
Mailing Address - City:OXFORD
Mailing Address - State:AL
Mailing Address - Zip Code:36203-3459
Mailing Address - Country:US
Mailing Address - Phone:256-231-2900
Mailing Address - Fax:
Practice Address - Street 1:400 OXFORD EXCHANGE BLVD
Practice Address - Street 2:
Practice Address - City:OXFORD
Practice Address - State:AL
Practice Address - Zip Code:36203-3459
Practice Address - Country:US
Practice Address - Phone:256-231-2900
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-09-09
Last Update Date:2011-09-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL16812183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist