Provider Demographics
NPI:1548808819
Name:KUEHL, KRISTA (PHARM D)
Entity type:Individual
Prefix:
First Name:KRISTA
Middle Name:
Last Name:KUEHL
Suffix:
Gender:F
Credentials:PHARM D
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2 SHENANDOAH DR
Mailing Address - Street 2:
Mailing Address - City:LAFAYETTE
Mailing Address - State:IN
Mailing Address - Zip Code:47905-5925
Mailing Address - Country:US
Mailing Address - Phone:765-446-1245
Mailing Address - Fax:
Practice Address - Street 1:2 SHENANDOAH DR
Practice Address - Street 2:
Practice Address - City:LAFAYETTE
Practice Address - State:IN
Practice Address - Zip Code:47905-5925
Practice Address - Country:US
Practice Address - Phone:765-446-1245
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-12-17
Last Update Date:2019-12-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN26024620A183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist