Provider Demographics
NPI:1669855698
Name:TAPIA, KRYSTLE (PHARMD, PHC)
Entity type:Individual
Prefix:
First Name:KRYSTLE
Middle Name:
Last Name:TAPIA
Suffix:
Gender:F
Credentials:PHARMD, PHC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1131 UNIVERSITY BLVD NE STE G
Mailing Address - Street 2:
Mailing Address - City:ALBUQUERQUE
Mailing Address - State:NM
Mailing Address - Zip Code:87102-1738
Mailing Address - Country:US
Mailing Address - Phone:505-272-2341
Mailing Address - Fax:505-272-8140
Practice Address - Street 1:1131 UNIVERSITY BLVD NE STE G
Practice Address - Street 2:
Practice Address - City:ALBUQUERQUE
Practice Address - State:NM
Practice Address - Zip Code:87102-1738
Practice Address - Country:US
Practice Address - Phone:505-272-2341
Practice Address - Fax:505-272-8140
Is Sole Proprietor?:No
Enumeration Date:2015-07-08
Last Update Date:2023-07-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NMRP000081621835P0018X
NMPC000002491835P0018X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1835P0018XPharmacy Service ProvidersPharmacistPharmacist Clinician (PhC)/ Clinical Pharmacy Specialist