Provider Demographics
NPI:1770690190
Name:KOUSKI, KRISTIN MARIE (PHARM D)
Entity Type:Individual
Prefix:DR
First Name:KRISTIN
Middle Name:MARIE
Last Name:KOUSKI
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 1:11626 BELVEDERE VISTA LN
Mailing Address - Street 2:APT. 304
Mailing Address - City:RICHMOND
Mailing Address - State:VA
Mailing Address - Zip Code:23235-4363
Mailing Address - Country:US
Mailing Address - Phone:804-840-4180
Mailing Address - Fax:
Practice Address - Street 1:2024 STAPLES MILL RD
Practice Address - Street 2:
Practice Address - City:RICHMOND
Practice Address - State:VA
Practice Address - Zip Code:23230-3109
Practice Address - Country:US
Practice Address - Phone:804-288-6318
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-08-23
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0202207560183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist