Provider Demographics
NPI:1497185573
Name:MONROE, KYNDALL MICHELLE (PHARMD, RPH)
Entity Type:Individual
Prefix:DR
First Name:KYNDALL
Middle Name:MICHELLE
Last Name:MONROE
Suffix:
Gender:F
Credentials:PHARMD, RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2950 CENTRAL AVE SE
Mailing Address - Street 2:
Mailing Address - City:ALBUQUERQUE
Mailing Address - State:NM
Mailing Address - Zip Code:87106-2263
Mailing Address - Country:US
Mailing Address - Phone:505-262-1745
Mailing Address - Fax:
Practice Address - Street 1:2950 CENTRAL AVE SE
Practice Address - Street 2:
Practice Address - City:ALBUQUERQUE
Practice Address - State:NM
Practice Address - Zip Code:87106-2263
Practice Address - Country:US
Practice Address - Phone:505-262-1745
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-11-26
Last Update Date:2013-11-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NMRP0008097183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist