Provider Demographics
NPI:1255932075
Name:HARPER, KRISTIN (PHARMD, RPH)
Entity type:Individual
Prefix:
First Name:KRISTIN
Middle Name:
Last Name:HARPER
Suffix:
Gender:F
Credentials:PHARMD, RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:606 FOREST LN
Mailing Address - Street 2:
Mailing Address - City:SUMMERSVILLE
Mailing Address - State:WV
Mailing Address - Zip Code:26651-1848
Mailing Address - Country:US
Mailing Address - Phone:304-288-1871
Mailing Address - Fax:304-872-2382
Practice Address - Street 1:200 WAL ST
Practice Address - Street 2:
Practice Address - City:SUMMERSVILLE
Practice Address - State:WV
Practice Address - Zip Code:26651-2100
Practice Address - Country:US
Practice Address - Phone:304-872-7039
Practice Address - Fax:304-872-2382
Is Sole Proprietor?:Yes
Enumeration Date:2020-11-06
Last Update Date:2020-11-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WVRP0007047183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist