Provider Demographics
NPI:1639452857
Name:CRINE, KIMBERLY DIANE (PHARMD)
Entity Type:Individual
Prefix:DR
First Name:KIMBERLY
Middle Name:DIANE
Last Name:CRINE
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7311 E 29TH DR
Mailing Address - Street 2:
Mailing Address - City:DENVER
Mailing Address - State:CO
Mailing Address - Zip Code:80238-2964
Mailing Address - Country:US
Mailing Address - Phone:720-214-5332
Mailing Address - Fax:720-214-5335
Practice Address - Street 1:7311 E 29TH DR
Practice Address - Street 2:
Practice Address - City:DENVER
Practice Address - State:CO
Practice Address - Zip Code:80238-2964
Practice Address - Country:US
Practice Address - Phone:720-214-5332
Practice Address - Fax:720-214-5335
Is Sole Proprietor?:No
Enumeration Date:2011-09-23
Last Update Date:2011-09-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO17728183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist