Provider Demographics
NPI:1265744304
Name:TRAMMELL, KRISTEN B (PHARMD)
Entity type:Individual
Prefix:DR
First Name:KRISTEN
Middle Name:B
Last Name:TRAMMELL
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 1:135 VISTA DR
Mailing Address - Street 2:
Mailing Address - City:MOORE
Mailing Address - State:SC
Mailing Address - Zip Code:29369-9482
Mailing Address - Country:US
Mailing Address - Phone:864-587-1582
Mailing Address - Fax:
Practice Address - Street 1:4010 ANDERSON MILL RD
Practice Address - Street 2:
Practice Address - City:SPARTANBURG
Practice Address - State:SC
Practice Address - Zip Code:29301-3502
Practice Address - Country:US
Practice Address - Phone:864-576-3788
Practice Address - Fax:864-576-6356
Is Sole Proprietor?:Yes
Enumeration Date:2010-07-06
Last Update Date:2010-07-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC11706183500000X
NC14868183500000X
TX39171183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist