Provider Demographics
NPI:1952710691
Name:SUTTON, KRISTEN WHEELES (PHARMD)
Entity Type:Individual
Prefix:
First Name:KRISTEN
Middle Name:WHEELES
Last Name:SUTTON
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:
Other - First Name:KRISTEN
Other - Middle Name:ELIZABETH
Other - Last Name:WHEELES
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PHARMD
Mailing Address - Street 1:3605 SANDY PLAINS RD STE 200
Mailing Address - Street 2:
Mailing Address - City:MARIETTA
Mailing Address - State:GA
Mailing Address - Zip Code:30066-3066
Mailing Address - Country:US
Mailing Address - Phone:770-578-6800
Mailing Address - Fax:
Practice Address - Street 1:3605 SANDY PLAINS RD STE 200
Practice Address - Street 2:
Practice Address - City:MARIETTA
Practice Address - State:GA
Practice Address - Zip Code:30066-3066
Practice Address - Country:US
Practice Address - Phone:770-578-6800
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-08-06
Last Update Date:2023-02-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
COPHA.0020413183500000X
GARPH029079183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist