Healthcare Provider Details

I. General information

NPI: 1992617542
Provider Name (Legal Business Name): KRISTEN LONGSTRETH PHARMD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/18/2026
Last Update Date: 09/18/2026
Certification Date: 09/18/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4600 MCAULEY PL STE 100
BLUE ASH OH
45242-4769
US

IV. Provider business mailing address

4600 MCAULEY PL STE 100
BLUE ASH OH
45242-4769
US

V. Phone/Fax

Practice location:
  • Phone: 877-220-5972
  • Fax:
Mailing address:
  • Phone: 877-220-5972
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code1835P2201X
TaxonomyAmbulatory Care Pharmacist
License NumberRP044562L
License Number StatePA
# 2
Primary TaxonomyY
Taxonomy Code1835P2201X
TaxonomyAmbulatory Care Pharmacist
License Number03324091
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: