MEDICARE: MS. KRISTEN LEA MAZANEC SHAMLIN PHARMD.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	183500000X	Pharmacist	PD11419	AR

General Provider Information

NPI Number	:	1861701823
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MS. KRISTEN LEA MAZANEC SHAMLIN PHARMD.

Provider Business Mailing Address
First Line	:	5500 CENTRAL AVE STE A
Second Line	:
City	:	HOT SPRINGS
State	:	AR
Zip	:	71913-9712
Country	:	US
Telephone Number	:	501-463-9922
Fax Number	:	501-463-9925

Provider Business Practice Location Address
First Line	:	5500 CENTRAL AVE STE A
Second Line	:
City	:	HOT SPRINGS
State	:	AR
Zip	:	71913-9712
Country	:	US
Telephone Number	:	501-463-9922
Fax Number	:	501-463-9925

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	09/24/2010
Last Update Date	:	09/15/2016

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