Provider Demographics
NPI:1497333470
Name:HALL, KRISTINA BURTON (CPHT)
Entity Type:Individual
Prefix:
First Name:KRISTINA
Middle Name:BURTON
Last Name:HALL
Suffix:
Gender:F
Credentials:CPHT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2221 PHILIP ST STE Q
Mailing Address - Street 2:
Mailing Address - City:NEW ORLEANS
Mailing Address - State:LA
Mailing Address - Zip Code:70113-2525
Mailing Address - Country:US
Mailing Address - Phone:504-292-7799
Mailing Address - Fax:
Practice Address - Street 1:2221 PHILIP ST STE Q
Practice Address - Street 2:
Practice Address - City:NEW ORLEANS
Practice Address - State:LA
Practice Address - Zip Code:70113-2525
Practice Address - Country:US
Practice Address - Phone:504-571-9120
Practice Address - Fax:504-524-5545
Is Sole Proprietor?:No
Enumeration Date:2021-03-31
Last Update Date:2021-04-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA008589183700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183700000XPharmacy Service ProvidersPharmacy Technician