Provider Demographics
NPI:1770601486
Name:SCHRADER, KRISTA RAE (CPHT)
Entity type:Individual
Prefix:MRS
First Name:KRISTA
Middle Name:RAE
Last Name:SCHRADER
Suffix:
Gender:F
Credentials:CPHT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:23 WELL VIEW LANE
Mailing Address - Street 2:
Mailing Address - City:KALISPELL
Mailing Address - State:MT
Mailing Address - Zip Code:59901
Mailing Address - Country:US
Mailing Address - Phone:406-257-2398
Mailing Address - Fax:406-756-3528
Practice Address - Street 1:310 SUNNYVIEW LN
Practice Address - Street 2:PHARMACY
Practice Address - City:KALISPELL
Practice Address - State:MT
Practice Address - Zip Code:59901-3129
Practice Address - Country:US
Practice Address - Phone:406-752-1761
Practice Address - Fax:406-756-3528
Is Sole Proprietor?:No
Enumeration Date:2007-03-27
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MT5599183700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183700000XPharmacy Service ProvidersPharmacy Technician