Provider Demographics
NPI:1790445005
Name:BAUERNSMITH, KRIS KENT (RPH)
Entity Type:Individual
Prefix:DR
First Name:KRIS
Middle Name:KENT
Last Name:BAUERNSMITH
Suffix:
Gender:M
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:40950 N IRONWOOD DR
Mailing Address - Street 2:
Mailing Address - City:QUEEN CREEK
Mailing Address - State:AZ
Mailing Address - Zip Code:85140-8915
Mailing Address - Country:US
Mailing Address - Phone:480-758-3320
Mailing Address - Fax:
Practice Address - Street 1:40950 N IRONWOOD DR
Practice Address - Street 2:
Practice Address - City:QUEEN CREEK
Practice Address - State:AZ
Practice Address - Zip Code:85140-8915
Practice Address - Country:US
Practice Address - Phone:480-758-3316
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-12-28
Last Update Date:2021-12-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZS025684183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes183500000XPharmacy Service ProvidersPharmacistGroup - Multi-Specialty