Provider Demographics
NPI:1881183234
Name:GOLDEN, KRISTIE NICOLE (PHARMD)
Entity Type:Individual
Prefix:DR
First Name:KRISTIE
Middle Name:NICOLE
Last Name:GOLDEN
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 1:3060 FRANKLIN TER
Mailing Address - Street 2:
Mailing Address - City:JOHNSON CITY
Mailing Address - State:TN
Mailing Address - Zip Code:37604-4123
Mailing Address - Country:US
Mailing Address - Phone:423-282-2124
Mailing Address - Fax:423-282-2285
Practice Address - Street 1:3060 FRANKLIN TER
Practice Address - Street 2:
Practice Address - City:JOHNSON CITY
Practice Address - State:TN
Practice Address - Zip Code:37604-4123
Practice Address - Country:US
Practice Address - Phone:423-282-2124
Practice Address - Fax:423-282-2285
Is Sole Proprietor?:No
Enumeration Date:2018-05-01
Last Update Date:2018-05-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA202206916183500000X
NC17536183500000X
TN21831183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist