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General NPI Number Information
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NPI Number | 1083804645
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Entity Type | Individual
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Provider Name | KRISTINA MCKENZIE PHARMD
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Gender | Female
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Dates
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Enumeration Date | 07/30/2007
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Last Update Date | 05/19/2009
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Provider Practice Location Address
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Address Line | 10764 NORTH ST
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City | GARRETTSVILLE
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State | OH
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Zip | 44231-1016
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Country | US
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Telephone | 330-527-2828
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Fax |
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Provider Business Mailing Address
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Address Line | 10764 NORTH STREET
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City | GARRETTSVILLE
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State | OH
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Zip | 44321-1016
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Country | US
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Telephone | 330-527-2828
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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 | 183500000X
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Taxonomy Name | Pharmacist
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License Number | 10892
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License Number State | OR
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