Healthcare Provider Details

I. General information

NPI: 1184536583
Provider Name (Legal Business Name): CRISTYN COLLIER FLEISCH PHARMD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/21/2026
Last Update Date: 09/21/2026
Certification Date: 09/16/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

13845 CONLAN CIR
CHARLOTTE NC
28277-2705
US

IV. Provider business mailing address

6301 STOXMEADE DR
MINT HILL NC
28227-4194
US

V. Phone/Fax

Practice location:
  • Phone: 704-544-2092
  • Fax:
Mailing address:
  • Phone: 513-218-9230
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License Number33254
License Number StateNC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: