Provider Demographics
NPI:1841643848
Name:GULBRANSEN, KRYSTAL (PHARMD)
Entity type:Individual
Prefix:
First Name:KRYSTAL
Middle Name:
Last Name:GULBRANSEN
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 1:735 HARDING PL
Mailing Address - Street 2:
Mailing Address - City:NASHVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37211-4357
Mailing Address - Country:US
Mailing Address - Phone:615-781-1282
Mailing Address - Fax:
Practice Address - Street 1:426 21ST AVE S
Practice Address - Street 2:
Practice Address - City:NASHVILLE
Practice Address - State:TN
Practice Address - Zip Code:37203-2424
Practice Address - Country:US
Practice Address - Phone:615-321-2590
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-07-14
Last Update Date:2020-11-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN43702183500000X
VA0202215038183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist