Provider Demographics
NPI:1942291539
Name:CERVIN, KRISTINE M (PHARMD)
Entity type:Individual
Prefix:MS
First Name:KRISTINE
Middle Name:M
Last Name:CERVIN
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 1:67785 275TH ST
Mailing Address - Street 2:
Mailing Address - City:DARWIN
Mailing Address - State:MN
Mailing Address - Zip Code:55324-5013
Mailing Address - Country:US
Mailing Address - Phone:612-597-7004
Mailing Address - Fax:
Practice Address - Street 1:4801 VETERANS DR
Practice Address - Street 2:
Practice Address - City:SAINT CLOUD
Practice Address - State:MN
Practice Address - Zip Code:56303-2015
Practice Address - Country:US
Practice Address - Phone:320-252-1670
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2005-11-02
Last Update Date:2025-05-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN1177581835P0018X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1835P0018XPharmacy Service ProvidersPharmacistPharmacist Clinician (PhC)/ Clinical Pharmacy Specialist