Provider Demographics
NPI:1023323631
Name:BOWSER, KRISTINA (PHARM D)
Entity type:Individual
Prefix:
First Name:KRISTINA
Middle Name:
Last Name:BOWSER
Suffix:
Gender:F
Credentials:PHARM D
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:123 WHARTON ST
Mailing Address - Street 2:
Mailing Address - City:PHILADELPHIA
Mailing Address - State:PA
Mailing Address - Zip Code:19147-5426
Mailing Address - Country:US
Mailing Address - Phone:609-519-1376
Mailing Address - Fax:
Practice Address - Street 1:10 SNYDER AVE
Practice Address - Street 2:
Practice Address - City:PHILADELPHIA
Practice Address - State:PA
Practice Address - Zip Code:19148-2700
Practice Address - Country:US
Practice Address - Phone:215-465-3270
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-08-09
Last Update Date:2016-06-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ28RI03370000183500000X
PARP445148183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist