Provider Demographics
NPI:1710533872
Name:DANIELS, KRISTIN UTLEY (PHARMD)
Entity Type:Individual
Prefix:DR
First Name:KRISTIN
Middle Name:UTLEY
Last Name:DANIELS
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:PO BOX 701
Mailing Address - Street 2:
Mailing Address - City:FLATWOODS
Mailing Address - State:KY
Mailing Address - Zip Code:41139-0701
Mailing Address - Country:US
Mailing Address - Phone:606-836-4313
Mailing Address - Fax:606-217-6464
Practice Address - Street 1:903 BELLEFONTE RD STE A
Practice Address - Street 2:
Practice Address - City:FLATWOODS
Practice Address - State:KY
Practice Address - Zip Code:41139-2005
Practice Address - Country:US
Practice Address - Phone:606-836-4313
Practice Address - Fax:606-217-6464
Is Sole Proprietor?:No
Enumeration Date:2019-08-14
Last Update Date:2019-08-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY015348183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist