Provider Demographics
NPI:1770041576
Name:LASSLEY, KRISTI (PHARM D)
Entity Type:Individual
Prefix:
First Name:KRISTI
Middle Name:
Last Name:LASSLEY
Suffix:
Gender:F
Credentials:PHARM D
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:145 EAST BROADWAY
Mailing Address - Street 2:
Mailing Address - City:DRUMRIGHT
Mailing Address - State:OK
Mailing Address - Zip Code:74030
Mailing Address - Country:US
Mailing Address - Phone:918-352-9301
Mailing Address - Fax:918-352-4255
Practice Address - Street 1:145 EAST BROADWAY
Practice Address - Street 2:
Practice Address - City:DRUMRIGHT
Practice Address - State:OK
Practice Address - Zip Code:74030
Practice Address - Country:US
Practice Address - Phone:918-352-9301
Practice Address - Fax:918-352-4255
Is Sole Proprietor?:No
Enumeration Date:2019-03-11
Last Update Date:2019-03-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK14551183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist