Provider Demographics
NPI:1710363825
Name:ARMENTOR, KRISTA I (RPH)
Entity Type:Individual
Prefix:MRS
First Name:KRISTA
Middle Name:
Last Name:ARMENTOR
Suffix:I
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 1:1150 W SAINT PETER ST
Mailing Address - Street 2:
Mailing Address - City:NEW IBERIA
Mailing Address - State:LA
Mailing Address - Zip Code:70560-3558
Mailing Address - Country:US
Mailing Address - Phone:337-367-9347
Mailing Address - Fax:
Practice Address - Street 1:1150 W SAINT PETER ST
Practice Address - Street 2:
Practice Address - City:NEW IBERIA
Practice Address - State:LA
Practice Address - Zip Code:70560-3558
Practice Address - Country:US
Practice Address - Phone:337-367-9347
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-07-31
Last Update Date:2015-07-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA16798183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist