Healthcare Provider Details

I. General information

NPI: 1447669809
Provider Name (Legal Business Name): KRISTEN HYDE PHARM D, R.PH.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: KRISTEN HUBBARD

II. Dates (important events)

Enumeration Date: 08/10/2014
Last Update Date: 06/26/2026
Certification Date: 06/26/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

50 2ND ST S
NAMPA ID
83651-3700
US

IV. Provider business mailing address

50 2ND ST S
NAMPA ID
83651-3700
US

V. Phone/Fax

Practice location:
  • Phone: 208-465-2836
  • Fax: 208-465-2833
Mailing address:
  • Phone: 208-465-2836
  • Fax: 208-465-2833

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License NumberP7080
License Number StateID

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: