Provider Demographics
NPI:1255512471
Name:MISHLER, KRISTIE MARLENE (PHARMD)
Entity type:Individual
Prefix:DR
First Name:KRISTIE
Middle Name:MARLENE
Last Name:MISHLER
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 1:4815 POWNER CT
Mailing Address - Street 2:
Mailing Address - City:WILLIAMSBURG
Mailing Address - State:VA
Mailing Address - Zip Code:23188-1791
Mailing Address - Country:US
Mailing Address - Phone:757-345-5868
Mailing Address - Fax:
Practice Address - Street 1:731 E ROCHAMBEAU DR
Practice Address - Street 2:
Practice Address - City:WILLIAMSBURG
Practice Address - State:VA
Practice Address - Zip Code:23188-2187
Practice Address - Country:US
Practice Address - Phone:757-220-3999
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-11-15
Last Update Date:2007-11-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0202206536183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist