Provider Demographics
NPI:1497249569
Name:ZERBY, KRISTIN (RPH)
Entity Type:Individual
Prefix:
First Name:KRISTIN
Middle Name:
Last Name:ZERBY
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:PO BOX 398
Mailing Address - Street 2:
Mailing Address - City:CURTIS
Mailing Address - State:MI
Mailing Address - Zip Code:49820-0398
Mailing Address - Country:US
Mailing Address - Phone:906-586-3333
Mailing Address - Fax:
Practice Address - Street 1:W17220 MAIN ST
Practice Address - Street 2:
Practice Address - City:CURTIS
Practice Address - State:MI
Practice Address - Zip Code:49820
Practice Address - Country:US
Practice Address - Phone:906-586-3333
Practice Address - Fax:866-211-6366
Is Sole Proprietor?:Yes
Enumeration Date:2018-06-21
Last Update Date:2018-06-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI5302032945183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI1821195199Medicaid