Provider Demographics
NPI:1952136293
Name:BURROWS, KRISTIN BLAIR (PHARMD)
Entity type:Individual
Prefix:
First Name:KRISTIN
Middle Name:BLAIR
Last Name:BURROWS
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 1:192 SE SONETO CT
Mailing Address - Street 2:
Mailing Address - City:PORT SAINT LUCIE
Mailing Address - State:FL
Mailing Address - Zip Code:34983-2031
Mailing Address - Country:US
Mailing Address - Phone:561-567-5649
Mailing Address - Fax:
Practice Address - Street 1:2040 58TH AVE
Practice Address - Street 2:
Practice Address - City:VERO BEACH
Practice Address - State:FL
Practice Address - Zip Code:32966-4646
Practice Address - Country:US
Practice Address - Phone:772-563-2065
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-09-05
Last Update Date:2024-09-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPS67640183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist