Provider Demographics
NPI:1689811416
Name:NEAFUS, KRISTIN
Entity Type:Individual
Prefix:DR
First Name:KRISTIN
Middle Name:
Last Name:NEAFUS
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:KRISTIN
Other - Middle Name:
Other - Last Name:ANDERSON
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PHARMD
Mailing Address - Street 1:12 WILDFLOWER PL
Mailing Address - Street 2:
Mailing Address - City:NORTH OAKS
Mailing Address - State:MN
Mailing Address - Zip Code:55127-6221
Mailing Address - Country:US
Mailing Address - Phone:651-340-1318
Mailing Address - Fax:
Practice Address - Street 1:12 WILDFLOWER PL
Practice Address - Street 2:
Practice Address - City:NORTH OAKS
Practice Address - State:MN
Practice Address - Zip Code:55127-6221
Practice Address - Country:US
Practice Address - Phone:651-340-1318
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-01-15
Last Update Date:2009-01-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN1165721835P0018X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1835P0018XPharmacy Service ProvidersPharmacistPharmacist Clinician (PhC)/ Clinical Pharmacy Specialist