Provider Demographics
NPI:1205353547
Name:ROSS, KRISTAL LYNN (PHARMD)
Entity type:Individual
Prefix:DR
First Name:KRISTAL
Middle Name:LYNN
Last Name:ROSS
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 1:939 GIOVANNI LN
Mailing Address - Street 2:
Mailing Address - City:IRWIN
Mailing Address - State:PA
Mailing Address - Zip Code:15642-6520
Mailing Address - Country:US
Mailing Address - Phone:412-401-1909
Mailing Address - Fax:
Practice Address - Street 1:939 GIOVANNI LANE
Practice Address - Street 2:
Practice Address - City:IRWIN
Practice Address - State:PA
Practice Address - Zip Code:15642
Practice Address - Country:US
Practice Address - Phone:412-401-1909
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-08-28
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PARP439885183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist