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General NPI Number Information
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NPI Number | 1063191500
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Entity Type | Individual
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Provider Name | SIERRA BROOKE KREFT PHARMD, BCPS
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Gender | Female
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Dates
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Enumeration Date | 07/12/2023
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Last Update Date | 07/12/2023
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Provider Practice Location Address
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Address Line | 1532 32ND AVE S
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City | FARGO
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State | ND
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Zip | 58103-5987
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Country | US
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Telephone | 701-478-8155
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Fax |
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Provider Business Mailing Address
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Address Line | 7898 NORTHERN LIGHTS AVE
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City | HORACE
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State | ND
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Zip | 58047-3704
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Country | US
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Telephone | 701-471-2171
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1835P0018X
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Taxonomy Name | Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist
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License Number | 124500
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License Number State | MN
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Taxonomy #2
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Taxonomy Code | 1835P0018X
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Taxonomy Name | Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist
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License Number | RPH6146
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License Number State | ND
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