Provider Demographics
NPI:1982994968
Name:SLUPE, KRISTINE LYNNE (RPH)
Entity Type:Individual
Prefix:
First Name:KRISTINE
Middle Name:LYNNE
Last Name:SLUPE
Suffix:
Gender:F
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:200 GREATER BUTLER MART
Mailing Address - Street 2:
Mailing Address - City:BUTLER
Mailing Address - State:PA
Mailing Address - Zip Code:16001-3283
Mailing Address - Country:US
Mailing Address - Phone:724-282-7808
Mailing Address - Fax:724-282-9768
Practice Address - Street 1:200 GREATER BUTLER MART
Practice Address - Street 2:
Practice Address - City:BUTLER
Practice Address - State:PA
Practice Address - Zip Code:16001-3283
Practice Address - Country:US
Practice Address - Phone:724-282-7808
Practice Address - Fax:724-282-9768
Is Sole Proprietor?:No
Enumeration Date:2011-04-12
Last Update Date:2011-04-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PA036931L183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist