Provider Demographics
NPI:1740565472
Name:SHOWSTEAD, KRISTEN LEIGH (PHARMD)
Entity Type:Individual
Prefix:DR
First Name:KRISTEN
Middle Name:LEIGH
Last Name:SHOWSTEAD
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 1:767 CHIEF JUSTICE CUSHING HWY
Mailing Address - Street 2:
Mailing Address - City:COHASSET
Mailing Address - State:MA
Mailing Address - Zip Code:02025-2141
Mailing Address - Country:US
Mailing Address - Phone:781-383-1772
Mailing Address - Fax:781-383-6146
Practice Address - Street 1:767 CHIEF JUSTICE CUSHING HWY
Practice Address - Street 2:
Practice Address - City:COHASSET
Practice Address - State:MA
Practice Address - Zip Code:02025-2141
Practice Address - Country:US
Practice Address - Phone:781-383-1772
Practice Address - Fax:781-383-6146
Is Sole Proprietor?:Yes
Enumeration Date:2011-10-13
Last Update Date:2011-10-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MAPH26809183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist