Provider Demographics
NPI:1972720753
Name:SPICER, KRISTINE LYNN (PHARMD)
Entity Type:Individual
Prefix:DR
First Name:KRISTINE
Middle Name:LYNN
Last Name:SPICER
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 1:3675 MONAGHAN POINT RD
Mailing Address - Street 2:
Mailing Address - City:ALPENA
Mailing Address - State:MI
Mailing Address - Zip Code:49707-8900
Mailing Address - Country:US
Mailing Address - Phone:989-595-3038
Mailing Address - Fax:989-595-3038
Practice Address - Street 1:1202 W CHISHOLM ST
Practice Address - Street 2:
Practice Address - City:ALPENA
Practice Address - State:MI
Practice Address - Zip Code:49707-1620
Practice Address - Country:US
Practice Address - Phone:989-354-3189
Practice Address - Fax:989-354-3286
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-20
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI5302033502183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist