Provider Demographics
NPI:1881226298
Name:STAFFORD, CHRISTINA L (PHARMD)
Entity Type:Individual
Prefix:
First Name:CHRISTINA
Middle Name:L
Last Name:STAFFORD
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 1:1506 COACH HOUSE CT
Mailing Address - Street 2:
Mailing Address - City:NIXA
Mailing Address - State:MO
Mailing Address - Zip Code:65714-8044
Mailing Address - Country:US
Mailing Address - Phone:314-623-3483
Mailing Address - Fax:
Practice Address - Street 1:1306 W BUSINESS LOOP 70
Practice Address - Street 2:
Practice Address - City:COLUMBIA
Practice Address - State:MO
Practice Address - Zip Code:65202-1325
Practice Address - Country:US
Practice Address - Phone:314-623-3483
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-02-04
Last Update Date:2020-02-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO20130327861835P1200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1835P1200XPharmacy Service ProvidersPharmacistPharmacotherapy