Provider Demographics
NPI:1609158765
Name:MIHOK, KRISTI LYN (RPH)
Entity Type:Individual
Prefix:
First Name:KRISTI
Middle Name:LYN
Last Name:MIHOK
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 1:1370 GLADE GULCH RD
Mailing Address - Street 2:
Mailing Address - City:CASTLE ROCK
Mailing Address - State:CO
Mailing Address - Zip Code:80104-9663
Mailing Address - Country:US
Mailing Address - Phone:303-308-1106
Mailing Address - Fax:
Practice Address - Street 1:650 S CHERRY ST
Practice Address - Street 2:SUITE 300
Practice Address - City:GLENDALE
Practice Address - State:CO
Practice Address - Zip Code:80246-1801
Practice Address - Country:US
Practice Address - Phone:303-794-3220
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-09-15
Last Update Date:2011-09-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO16719183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist