Provider Demographics
NPI:1205433935
Name:VALCIC, KIRSTEN (PHARMD)
Entity type:Individual
Prefix:DR
First Name:KIRSTEN
Middle Name:
Last Name:VALCIC
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 1:41119 N SUTTER LN
Mailing Address - Street 2:
Mailing Address - City:ANTHEM
Mailing Address - State:AZ
Mailing Address - Zip Code:85086-1515
Mailing Address - Country:US
Mailing Address - Phone:480-392-7189
Mailing Address - Fax:
Practice Address - Street 1:10602 N 32ND ST
Practice Address - Street 2:
Practice Address - City:PHOENIX
Practice Address - State:AZ
Practice Address - Zip Code:85028-3298
Practice Address - Country:US
Practice Address - Phone:602-996-1152
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-10-06
Last Update Date:2020-10-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZS024936183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist