Provider Demographics
NPI:1205351400
Name:TRAXLER, KRISTINA ANN (PHARMD)
Entity type:Individual
Prefix:DR
First Name:KRISTINA
Middle Name:ANN
Last Name:TRAXLER
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 1:1516 E MAIN ST
Mailing Address - Street 2:
Mailing Address - City:PLAINFIELD
Mailing Address - State:IN
Mailing Address - Zip Code:46168-1791
Mailing Address - Country:US
Mailing Address - Phone:317-838-9187
Mailing Address - Fax:
Practice Address - Street 1:1516 E MAIN ST
Practice Address - Street 2:
Practice Address - City:PLAINFIELD
Practice Address - State:IN
Practice Address - Zip Code:46168-1791
Practice Address - Country:US
Practice Address - Phone:317-838-9187
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-08-08
Last Update Date:2017-08-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN26027094A183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist