Provider Demographics
NPI:1760792899
Name:RINGWALD, KRISTA JOI (PHARMD)
Entity Type:Individual
Prefix:DR
First Name:KRISTA
Middle Name:JOI
Last Name:RINGWALD
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 1:125 E BOYSON RD
Mailing Address - Street 2:APT 807
Mailing Address - City:HIAWATHA
Mailing Address - State:IA
Mailing Address - Zip Code:52233-1209
Mailing Address - Country:US
Mailing Address - Phone:317-410-1223
Mailing Address - Fax:
Practice Address - Street 1:113 FIRST ST EAST
Practice Address - Street 2:
Practice Address - City:MOUNT VERNON
Practice Address - State:IA
Practice Address - Zip Code:52314
Practice Address - Country:US
Practice Address - Phone:319-895-6248
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-10-07
Last Update Date:2010-10-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN26023602A183500000X
IA21287183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist