Provider Demographics
NPI:1689263287
Name:PARRISH, KRISTEN (PHARMD)
Entity Type:Individual
Prefix:DR
First Name:KRISTEN
Middle Name:
Last Name:PARRISH
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 1:814 PHEASANT RUN CT W
Mailing Address - Street 2:
Mailing Address - City:PORT ORANGE
Mailing Address - State:FL
Mailing Address - Zip Code:32127-1141
Mailing Address - Country:US
Mailing Address - Phone:386-679-9807
Mailing Address - Fax:
Practice Address - Street 1:1657 TAYLOR RD STE 102
Practice Address - Street 2:
Practice Address - City:PORT ORANGE
Practice Address - State:FL
Practice Address - Zip Code:32128-7516
Practice Address - Country:US
Practice Address - Phone:386-317-8537
Practice Address - Fax:386-317-8540
Is Sole Proprietor?:Yes
Enumeration Date:2021-01-18
Last Update Date:2021-01-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPS35906183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist