Provider Demographics
NPI:1255614244
Name:FISHER, KRISTI T
Entity type:Individual
Prefix:DR
First Name:KRISTI
Middle Name:T
Last Name:FISHER
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1434 BRAEWOOD AVE
Mailing Address - Street 2:
Mailing Address - City:HIGHLANDS RANCH
Mailing Address - State:CO
Mailing Address - Zip Code:80129-5616
Mailing Address - Country:US
Mailing Address - Phone:303-868-6052
Mailing Address - Fax:
Practice Address - Street 1:4520 FLORENCE ST
Practice Address - Street 2:
Practice Address - City:DENVER
Practice Address - State:CO
Practice Address - Zip Code:80238-2410
Practice Address - Country:US
Practice Address - Phone:303-375-2600
Practice Address - Fax:720-375-2580
Is Sole Proprietor?:Yes
Enumeration Date:2011-09-26
Last Update Date:2013-02-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO17371183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist