Provider Demographics
NPI:1629226543
Name:SIMONS, KRISTEN MEGAN (RPH)
Entity Type:Individual
Prefix:MRS
First Name:KRISTEN
Middle Name:MEGAN
Last Name:SIMONS
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 1:304 HARDING WAY W
Mailing Address - Street 2:
Mailing Address - City:GALION
Mailing Address - State:OH
Mailing Address - Zip Code:44833
Mailing Address - Country:US
Mailing Address - Phone:419-468-5340
Mailing Address - Fax:419-462-1236
Practice Address - Street 1:304 HARDING WAY W
Practice Address - Street 2:
Practice Address - City:GALION
Practice Address - State:OH
Practice Address - Zip Code:44833
Practice Address - Country:US
Practice Address - Phone:419-468-5340
Practice Address - Fax:419-462-1236
Is Sole Proprietor?:Yes
Enumeration Date:2008-09-04
Last Update Date:2008-09-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH03328632183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist