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General NPI Number Information
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NPI Number | 1093375727
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Entity Type | Individual
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Provider Name | MRS. KRISTIANA HALES
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Gender | Female
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Dates
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Enumeration Date | 06/14/2019
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Last Update Date | 06/14/2019
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Provider Practice Location Address
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Address Line | 1350 N 500 E
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City | LOGAN
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State | UT
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Zip | 84341-2400
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Country | US
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Telephone | 435-716-1522
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Fax |
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Provider Business Mailing Address
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Address Line | 5267 W 12425 N
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City | GARLAND
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State | UT
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Zip | 84312-6701
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Country | US
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Telephone | 435-230-2717
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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 | 325673-1701
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License Number State | UT
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