Provider Demographics
NPI:1639466741
Name:ZORN, KRISTEN ELISABETH (PHARMD)
Entity type:Individual
Prefix:
First Name:KRISTEN
Middle Name:ELISABETH
Last Name:ZORN
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 1:4717 PRIOR DR
Mailing Address - Street 2:APARTMENT #156
Mailing Address - City:WILMINGTON
Mailing Address - State:NC
Mailing Address - Zip Code:28412-2279
Mailing Address - Country:US
Mailing Address - Phone:315-420-6022
Mailing Address - Fax:
Practice Address - Street 1:4717 PRIOR DR
Practice Address - Street 2:APARTMENT #156
Practice Address - City:WILMINGTON
Practice Address - State:NC
Practice Address - Zip Code:28412-2279
Practice Address - Country:US
Practice Address - Phone:315-420-6022
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-07-09
Last Update Date:2011-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC21955183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist