Provider Demographics
NPI:1679940357
Name:TALBOT, KRISTEN (PHARM D)
Entity Type:Individual
Prefix:
First Name:KRISTEN
Middle Name:
Last Name:TALBOT
Suffix:
Gender:F
Credentials:PHARM D
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5090 HIDDEN POINT DR
Mailing Address - Street 2:
Mailing Address - City:CEDAR BLUFF
Mailing Address - State:AL
Mailing Address - Zip Code:35959-5095
Mailing Address - Country:US
Mailing Address - Phone:256-393-2271
Mailing Address - Fax:
Practice Address - Street 1:101 CHESNUT BYP
Practice Address - Street 2:
Practice Address - City:CENTRE
Practice Address - State:AL
Practice Address - Zip Code:35960-1427
Practice Address - Country:US
Practice Address - Phone:256-927-4346
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-08-28
Last Update Date:2015-08-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL15953183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist
Provider Identifiers
StateIdentifier IDID TypeIssuer
AL15953OtherSTATE LISCENSE