Provider Demographics
NPI:1851614465
Name:WEBER, KRISTEN (RPH)
Entity Type:Individual
Prefix:
First Name:KRISTEN
Middle Name:
Last Name:WEBER
Suffix:
Gender:F
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:525 N FRALEY ST
Mailing Address - Street 2:
Mailing Address - City:KANE
Mailing Address - State:PA
Mailing Address - Zip Code:16735-1162
Mailing Address - Country:US
Mailing Address - Phone:814-837-4932
Mailing Address - Fax:814-837-4318
Practice Address - Street 1:525 N FRALEY ST
Practice Address - Street 2:
Practice Address - City:KANE
Practice Address - State:PA
Practice Address - Zip Code:16735-1162
Practice Address - Country:US
Practice Address - Phone:814-837-4932
Practice Address - Fax:814-837-4318
Is Sole Proprietor?:Yes
Enumeration Date:2010-03-10
Last Update Date:2010-03-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PARP0286961183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist