Provider Demographics
NPI:1548812191
Name:FLEMING, KRISTIN (PHARMD)
Entity type:Individual
Prefix:
First Name:KRISTIN
Middle Name:
Last Name:FLEMING
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 1:408 BRUNSWICK DR APT 13
Mailing Address - Street 2:
Mailing Address - City:LAFAYETTE
Mailing Address - State:IN
Mailing Address - Zip Code:47909-6983
Mailing Address - Country:US
Mailing Address - Phone:219-242-0294
Mailing Address - Fax:
Practice Address - Street 1:505 W MAIN ST
Practice Address - Street 2:
Practice Address - City:DELPHI
Practice Address - State:IN
Practice Address - Zip Code:46923-1441
Practice Address - Country:US
Practice Address - Phone:765-564-4117
Practice Address - Fax:765-564-3837
Is Sole Proprietor?:No
Enumeration Date:2019-07-14
Last Update Date:2019-07-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN26026687A183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist